Individual
TANYA NICHOLE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
109 CLUBHOUSE CT, MORRILTON, AR 72110-9171
(501) 208-3408
Mailing address
109 CLUBHOUSE CT, MORRILTON, AR 72110-9171
(501) 208-3408
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7935
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163948721
—
AR
Enumeration date
04/09/2007
Last updated
02/26/2013
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