Individual
JENNIFER THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
(662) 680-6416
Mailing address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
(662) 680-6416
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018203
—
MS
Enumeration date
09/06/2019
Last updated
09/06/2019
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