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General NPI Number Information
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NPI Number | 1952499675
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Entity Type | Individual
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Provider Name | KERRY-LYNN SUZANNE THOMAS M.ED.
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 1055 DRESSER CT BUILDING 2
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City | RALEIGH
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State | NC
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Zip | 27609-7323
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Country | US
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Telephone | 919-876-3130
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Fax | 919-876-3134
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Provider Business Mailing Address
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Address Line | 113 ABINGDON CT APT 1A
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City | CARY
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State | NC
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Zip | 27513-3244
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Country | US
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Telephone | 919-771-9285
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5469
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License Number State | NC
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