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General NPI Number Information
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NPI Number | 1285463422
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Entity Type | Individual
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Provider Name | JENNIFER L THOMAS BCBA
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Gender | Female
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Dates
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Enumeration Date | 07/27/2024
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Last Update Date | 07/27/2024
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Provider Practice Location Address
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Address Line | 3831 FREDERICK AVE # 212
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-3020
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Country | US
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Telephone | 816-888-6226
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Fax |
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Provider Business Mailing Address
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Address Line | 21 BAYBERRY DR
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City | ELKTON
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State | MD
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Zip | 21921-7119
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Country | US
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Telephone | 443-206-2695
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-60083
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License Number State |
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