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General NPI Number Information
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NPI Number | 1104073279
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Entity Type | Individual
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Provider Name | REBECCA RAYNOR THOMAS MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 1913 E 9TH ST
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City | GREENVILLE
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State | NC
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Zip | 27858-2922
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Country | US
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Telephone | 252-758-4728
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Fax | 252-758-9465
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Provider Business Mailing Address
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Address Line | PO BOX 191
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City | FALKLAND
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State | NC
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Zip | 27827-0191
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Country | US
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Telephone | 252-341-2279
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 8130
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License Number State | NC
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