Individual
MRS. JACQUELINE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHPP
Contact information
Practice address
320 LEE AVE, EARLE, AR 72331-2159
(870) 792-7769
Mailing address
703 CALVIN AVERY DR, WEST MEMPHIS, AR 72301-6501
(870) 732-1878
(870) 702-7111
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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