Provider Demographics
NPI:1194226738
Name:THOMAS, LAWANDA
Entity Type:Individual
Prefix:MS
First Name:LAWANDA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LAWANDA
Other - Middle Name:
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:326 ARBOR PL
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-8040
Mailing Address - Country:US
Mailing Address - Phone:770-599-7512
Mailing Address - Fax:
Practice Address - Street 1:125 LEE BYRD RD
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-2310
Practice Address - Country:US
Practice Address - Phone:770-599-7512
Practice Address - Fax:833-619-7862
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist