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NPI Code Detail

MEDICARE: MARY THOMAS

MEDICARE:   MARY  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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1740613843
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY THOMAS
Provider Business Mailing Address
First Line : 8136 CIMARRON RIDGE DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-1663
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8136 CIMARRON RIDGE DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-1663
Country : US
Telephone Number : 702-742-6067
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2013
Last Update Date : 08/13/2013

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Directions to “ MARY THOMAS ” Practice Location

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