MEDICARE: MS. CYNTHIA MARIA THOMAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1205234275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA MARIA THOMAS

Provider Business Mailing Address
First Line	:	3430 E FLAMINGO RD STE 324
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5067
Country	:	US
Telephone Number	:	702-749-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3430 E FLAMINGO RD STE 324
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5067
Country	:	US
Telephone Number	:	702-749-3200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2014
Last Update Date	:	12/08/2014

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