Individual
AQUANDA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2011 S 25TH ST STE 108, FORT PIERCE, FL 34947-4795
(772) 242-1079
(772) 242-1296
Mailing address
2011 S 25TH ST STE 108, FORT PIERCE, FL 34947-4795
(772) 242-1079
(772) 242-1296
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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