Healthcare Provider Details

I. General information

NPI: 1538083167
Provider Name (Legal Business Name): MARGARET THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 S CULVER ST
LAWRENCEVILLE GA
30046-4805
US

IV. Provider business mailing address

576 DAURIAN DR
STATHAM GA
30666-1882
US

V. Phone/Fax

Practice location:
  • Phone: 404-458-0809
  • Fax:
Mailing address:
  • Phone: 651-367-9060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-460687
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: