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General NPI Number Information
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NPI Number | 1457966954
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Entity Type | Individual
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Provider Name | NAHBILA SONIA THAMES LMT
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Gender | Female
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 4765 HWY 78 STE C
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City | LILBURN
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State | GA
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Zip | 30047-4691
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Country | US
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Telephone | 404-454-1814
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Fax |
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Provider Business Mailing Address
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Address Line | 432 FRESHMAN DR # 432
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-5434
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Country | US
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Telephone | 205-529-0164
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Fax | 205-000-0000
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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 | 011309
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License Number State | GA
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