Provider Demographics
NPI:1871832741
Name:THOMASON, PAULINE C (SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAULINE
Middle Name:C
Last Name:THOMASON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4456
Mailing Address - Country:US
Mailing Address - Phone:864-231-6463
Mailing Address - Fax:
Practice Address - Street 1:1221 HARRIETT CIR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3757
Practice Address - Country:US
Practice Address - Phone:864-716-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2075235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist