Individual
AGATHA RENE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, BHRS, CM
Contact information
Practice address
RR 1, BOX 35D, BOLEY, OK 74829
(918) 667-3367
(918) 667-3387
Mailing address
RT. 1, BOX 122, BOLEY, OK 74829
(918) 667-3770
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
#7176
OK
Other
Enumeration date
11/09/2006
Last updated
07/09/2007
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