Provider Demographics
NPI:1346670049
Name:THOMAS, FELICIA L (MA SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MA SLP-CCC
Other - Prefix:MS
Other - First Name:FELICIA
Other - Middle Name:L
Other - Last Name:GIVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA SLP-CCC
Mailing Address - Street 1:3503 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-1711
Mailing Address - Country:US
Mailing Address - Phone:765-465-1001
Mailing Address - Fax:
Practice Address - Street 1:3503 HAMPTON CT
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-1711
Practice Address - Country:US
Practice Address - Phone:765-465-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004850A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist