Provider Demographics
NPI:1609648112
Name:THOMAS, ZOE JULIANA I
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:JULIANA
Last Name:THOMAS
Suffix:I
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 1:88 PARK ST APT 3
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-4485
Mailing Address - Country:US
Mailing Address - Phone:512-757-7480
Mailing Address - Fax:
Practice Address - Street 1:173 UNION STREET
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04402
Practice Address - Country:US
Practice Address - Phone:207-941-1612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC226681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical