Individual
AMY RANDALL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
105 JAZZ DR, PANAMA CITY, FL 32405-4906
(843) 271-4891
(850) 248-2468
Mailing address
105 JAZZ DR, PANAMA CITY, FL 32405-4906
(843) 271-4891
(850) 248-2468
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW19569
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW19569
LICENSE
FL
Enumeration date
10/21/2022
Last updated
10/21/2022
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