Provider Demographics
NPI:1558909804
Name:THOMAS, LAWANDA MICHELLE
Entity Type:Individual
Prefix:
First Name:LAWANDA
Middle Name:MICHELLE
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 1:4301 23RD PKWY APT 213
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-4449
Mailing Address - Country:US
Mailing Address - Phone:240-291-3692
Mailing Address - Fax:
Practice Address - Street 1:4301 23RD PKWY APT 213
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-4449
Practice Address - Country:US
Practice Address - Phone:240-219-3692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion