MEDICARE: SADIE A 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	:	1235587528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SADIE A THOMAS

Provider Business Mailing Address
First Line	:	1155 W 4TH ST
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89503-5172
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1155 W 4TH ST
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89503-5172
Country	:	US
Telephone Number	:	775-333-5222
Fax Number	:

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

Provider Enumeration Date	:	05/27/2016
Last Update Date	:	05/27/2016

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Directions to “ SADIE A THOMAS ” Practice Location

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