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General NPI Number Information
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NPI Number | 1245992288
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Entity Type | Individual
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Provider Name | ANGELA SELENE THOMAS
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Gender | Female
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Dates
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Enumeration Date | 10/07/2021
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 4001 9TH ST N STE 230
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City | ARLINGTON
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State | VA
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Zip | 22203-1900
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Country | US
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Telephone | 703-522-7637
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5545
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City | HYATTSVILLE
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State | MD
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Zip | 20782-0545
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Country | US
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Telephone |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019007669
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License Number State | VA
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