Provider Demographics
NPI:1710261813
Name:DAWN THOMAS
Entity Type:Organization
Organization Name:DAWN THOMAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP-CCC
Authorized Official - Phone:919-526-4028
Mailing Address - Street 1:1109 RIVER CHASE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-9708
Mailing Address - Country:US
Mailing Address - Phone:919-526-4028
Mailing Address - Fax:
Practice Address - Street 1:1109 RIVER CHASE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-9708
Practice Address - Country:US
Practice Address - Phone:919-526-4028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6293251E00000X, 252Y00000X, 283X00000X, 302R00000X, 3104A0625X, 314000000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No283X00000XHospitalsRehabilitation Hospital
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities