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Individual

AMY R THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED CFY-SLP

Contact information

Practice address
1641 MADISON AVE, TIFTON, GA 31794-3757
(229) 353-6188
Mailing address
907 18TH ST E, SUITE 150, TIFTON, GA 31794-3643
(229) 353-6188

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008491
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PCET001895
GA LICENSE
GA
Enumeration date
06/04/2013
Last updated
12/03/2014
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