Individual
ALEXANDRA DAINNE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 N DALTON ST, VALLIANT, OK 74764-8029
(580) 203-3600
Mailing address
804 N DALTON, VALLIANT, OK 74764
(580) 372-5518
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R083772071
CAQH
OK
Enumeration date
03/02/2021
Last updated
03/02/2021
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