Provider Demographics
NPI:1548748270
Name:THOMAS, CARLI ANNE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARLI
Middle Name:ANNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:CARLI
Other - Middle Name:ANNE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26639 VALLEY CENTER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91351-2376
Mailing Address - Country:US
Mailing Address - Phone:661-254-1842
Mailing Address - Fax:
Practice Address - Street 1:26639 VALLEY CENTER DR STE 101
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91351-2376
Practice Address - Country:US
Practice Address - Phone:661-254-1842
Practice Address - Fax:661-254-1862
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24450235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist