Provider Demographics
NPI:1417148990
Name:JOSEPH-THOMAS, SANDRA LENORA (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LENORA
Last Name:JOSEPH-THOMAS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 POND SPRINGS TRCE SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-1993
Mailing Address - Country:US
Mailing Address - Phone:301-452-7485
Mailing Address - Fax:
Practice Address - Street 1:1300 POND SPRINGS TRCE SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-1993
Practice Address - Country:US
Practice Address - Phone:301-452-7485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2023-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05340235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist