Provider Demographics
NPI:1861045536
Name:THOMAS, DENELEE FAITH (MS CCC-SLP BCBA)
Entity Type:Individual
Prefix:MRS
First Name:DENELEE
Middle Name:FAITH
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS CCC-SLP BCBA
Other - Prefix:
Other - First Name:DENELEE
Other - Middle Name:FAITH
Other - Last Name:LAGASSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP BCBA
Mailing Address - Street 1:222 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-2305
Mailing Address - Country:US
Mailing Address - Phone:508-615-6298
Mailing Address - Fax:
Practice Address - Street 1:222 RIVER ST
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-2305
Practice Address - Country:US
Practice Address - Phone:508-615-6298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2137103K00000X
MA7967235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst