Healthcare Provider Details

I. General information

NPI: 1720992894
Provider Name (Legal Business Name): DEBRA LOUISE THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S PARK ST
CASPER WY
82601-3337
US

IV. Provider business mailing address

510 S PARK ST
CASPER WY
82601-3337
US

V. Phone/Fax

Practice location:
  • Phone: 307-258-9314
  • Fax: 307-333-5408
Mailing address:
  • Phone: 307-258-9314
  • Fax: 307-333-5408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: