Provider Demographics
NPI:1225334022
Name:THOMAS, DORONETRA (MPA)
Entity Type:Individual
Prefix:MS
First Name:DORONETRA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7860 W SAHARA AVE
Mailing Address - Street 2:170
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1944
Mailing Address - Country:US
Mailing Address - Phone:720-985-7056
Mailing Address - Fax:
Practice Address - Street 1:7860 W SAHARA AVE
Practice Address - Street 2:170
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1944
Practice Address - Country:US
Practice Address - Phone:720-985-7056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner