Individual
STEPHANIE LORRAINE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 FIDDLERS RIDGE RD, VINE GROVE, KY 40175-1265
(270) 501-0382
Mailing address
111 FIDDLERS RIDGE RD, VINE GROVE, KY 40175-1265
(270) 501-0382
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
200172615
KY
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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