Individual
DWALLA LYNISE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 E 7TH ST, CHARLOTTE, NC 28204-6300
(704) 708-4271
Mailing address
5630 PACES GLEN AVE APT 1111, CHARLOTTE, NC 28212-1643
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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