Provider Demographics
NPI:1952079642
Name:NOBLE-ASH, THOMANISA (MS/SLP)
Entity Type:Individual
Prefix:
First Name:THOMANISA
Middle Name:
Last Name:NOBLE-ASH
Suffix:
Gender:F
Credentials:MS/SLP
Other - Prefix:
Other - First Name:THOMI
Other - Middle Name:
Other - Last Name:ASH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:310 N DIXIE HWY APT 110
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-6807
Mailing Address - Country:US
Mailing Address - Phone:317-384-9408
Mailing Address - Fax:
Practice Address - Street 1:310 N DIXIE HWY APT 110
Practice Address - Street 2:
Practice Address - City:LAKE WORTH BEACH
Practice Address - State:FL
Practice Address - Zip Code:33460-6807
Practice Address - Country:US
Practice Address - Phone:317-384-9408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22005063A235Z00000X
FLSA20134235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist