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Individual

AMY PATRICIA THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 508-6422
Mailing address
14454 BASILHAM LN, JACKSONVILLE, FL 32258-4423
(904) 955-9670

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA6674
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8873739
FL
Enumeration date
08/20/2007
Last updated
03/22/2011
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