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General NPI Number Information
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NPI Number | 1194376475
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Entity Type | Organization
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Legal Business Name | THOMAS THERAPY, PLLC
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Dates
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Enumeration Date | 09/26/2019
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 363 HIGHLAND COLONY PKWY
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City | RIDGELAND
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State | MS
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Zip | 39157-6035
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Country | US
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Telephone | 662-822-6266
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Fax | 833-901-0450
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Provider Business Mailing Address
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Address Line | 2457 WILD VALLEY DR
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City | JACKSON
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State | MS
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Zip | 39211-6233
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Country | US
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Telephone | 662-822-6266
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Fax | 833-901-0450
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARTINE CAMPBELL
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Credential |
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Telephone | 601-383-8120
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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 |
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License Number State |
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