Provider Demographics
NPI:1447767843
Name:THOMAS, LASHAWNTA MONIQUE
Entity Type:Individual
Prefix:
First Name:LASHAWNTA
Middle Name:MONIQUE
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 1:1231 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-5515
Mailing Address - Country:US
Mailing Address - Phone:513-242-1268
Mailing Address - Fax:
Practice Address - Street 1:7126 HIRSCH DR APT 231
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-4041
Practice Address - Country:US
Practice Address - Phone:513-641-0709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty