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General NPI Number Information
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NPI Number | 1225934748
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Entity Type | Individual
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Provider Name | ELCINDRA MAURITA THOMAS
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Gender | Female
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Dates
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Enumeration Date | 10/20/2026
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Last Update Date | 10/20/2026
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Provider Practice Location Address
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Address Line | 3400 LEBANON RD
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City | MURFREESBORO
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State | TN
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Zip | 37129-1392
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Country | US
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Telephone | 615-225-6708
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Fax |
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Provider Business Mailing Address
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Address Line | 302 S BILBRO AVE
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City | MURFREESBORO
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State | TN
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Zip | 37130-4408
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Country | US
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Telephone | 615-225-6708
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.116148
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License Number State | IL
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