Provider Demographics
NPI:1477099448
Name:THOMAS-TWILLEY, SAMIR J
Entity Type:Individual
Prefix:
First Name:SAMIR
Middle Name:J
Last Name:THOMAS-TWILLEY
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 1:6555 ABERCORN ST
Mailing Address - Street 2:SUITE 129
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5713
Mailing Address - Country:US
Mailing Address - Phone:912-224-8624
Mailing Address - Fax:
Practice Address - Street 1:6555 ABERCORN ST
Practice Address - Street 2:SUITE 129
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5713
Practice Address - Country:US
Practice Address - Phone:912-224-8624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)