Provider Demographics
NPI:1639660996
Name:THOMAS, ABIGALE ALLISON
Entity Type:Individual
Prefix:MISS
First Name:ABIGALE
Middle Name:ALLISON
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 1:7875 TAM OSHANTER BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-5341
Mailing Address - Country:US
Mailing Address - Phone:954-632-5921
Mailing Address - Fax:
Practice Address - Street 1:7875 TAM OSHANTER BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-5341
Practice Address - Country:US
Practice Address - Phone:954-632-5921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNAOtherNA