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Individual

MRS. JENNIFER RICE THOMAS

Active
Sole proprietor
Yes

Provider details

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

Contact information

Practice address
902 NORTHSIDE DR, PERRY, GA 31069-3344
(478) 987-1610
Mailing address
105 STARKY PL, WARNER ROBINS, GA 31088-8512
(478) 396-2096
(973) 965-4580

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004802
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000916319D
GA
05
000916319E
GA
Enumeration date
01/15/2007
Last updated
06/16/2009
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