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NPI Code Detail

MEDICARE: MRS. AMY RENEE THOMAS SLP

MEDICARE: MRS. AMY RENEE THOMAS SLP
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
1235Z00000XSpeech-Language Pathologist2283OK

General Provider Information

NPI Number : 1508164989
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY RENEE THOMAS SLP
Provider Business Mailing Address
First Line : 413 NW 140TH ST
Second Line :
City : EDMOND
State : OK
Zip : 73013-1974
Country : US
Telephone Number : 405-226-4560
Fax Number :
Provider Business Practice Location Address
First Line : 14715 BRISTOL PARK BLVD
Second Line :
City : EDMOND
State : OK
Zip : 73013-1894
Country : US
Telephone Number : 405-840-1686
Fax Number : 405-840-1060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2011
Last Update Date : 03/08/2011

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