Individual
MISS EVONNE NA THOMAS I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE ASSISTANT
Contact information
Practice address
412 W PAULDING RD, 412 WEST PAULDING ROAD, FORT WAYNE, IN 46807-3430
(260) 745-3619
Mailing address
412 W PAULDING RD, 412 WEST PAULDING ROAD, FORT WAYNE, IN 46807-3430
(260) 745-3619
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
51202447
IN
103K00000X
Behavior Analyst
Primary
8902603047
IN
103K00000X
Behavior Analyst
—
IN
Other
Enumeration date
02/24/2010
Last updated
02/24/2010
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