Individual
TIYA MONNETTE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 W PACIFIC AVE, HENDERSON, NV 89015-7376
(702) 565-1020
(702) 565-1035
Mailing address
5712 CLARENDON LN, NORTH LAS VEGAS, NV 89081-2424
(702) 480-8040
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
NV
Enumeration date
08/29/2019
Last updated
08/29/2019
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