Provider Demographics
NPI:1497192421
Name:THOMAS, LA SHARA YVONNE (BA)
Entity Type:Individual
Prefix:MS
First Name:LA SHARA
Middle Name:YVONNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6051 N BROOKLINE AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4289
Mailing Address - Country:US
Mailing Address - Phone:405-810-0054
Mailing Address - Fax:405-810-8977
Practice Address - Street 1:6051 N BROOKLINE AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4289
Practice Address - Country:US
Practice Address - Phone:405-810-0054
Practice Address - Fax:405-810-8977
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst