Provider Demographics
NPI:1215540349
Name:THOMAS, TONIELIA MAYON
Entity Type:Individual
Prefix:
First Name:TONIELIA
Middle Name:MAYON
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3761 GALAWAY CT
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-2276
Mailing Address - Country:US
Mailing Address - Phone:404-587-6696
Mailing Address - Fax:
Practice Address - Street 1:3761 GALAWAY CT
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-2276
Practice Address - Country:US
Practice Address - Phone:404-587-6696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist