Individual
MRS. MARY NICOLE THOMASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1531 HIGHLAND COLONY PKWY, MADISON, MS 39110-7469
(601) 707-3980
Mailing address
1465 LAKELAND DR, JACKSON, MS 39216-4719
(601) 352-7784
(769) 230-2863
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-27492
—
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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