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Individual

JESSICA THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS CCC-SLP

Contact information

Practice address
4501 MAIN ST, SUITE 5, SHALLOTTE, NC 28470-4589
(910) 612-1002
(910) 755-5864
Mailing address
1176 WOODBRIDGE LN SE, BOLIVIA, NC 28422-8969
(910) 612-1002
(910) 755-5864

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
3389
SC
235Z00000X
Speech-Language Pathologist
Primary
6026
NC

Other

Enumeration date
07/11/2011
Last updated
01/16/2012
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