Provider Demographics
NPI:1972876951
Name:THOMAS, MENYOUNDA KRISCHON (MS)
Entity Type:Individual
Prefix:MRS
First Name:MENYOUNDA
Middle Name:KRISCHON
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:MENYOUNDA
Other - Middle Name:KRISCHON
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 NW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-7220
Mailing Address - Country:US
Mailing Address - Phone:405-528-3562
Mailing Address - Fax:
Practice Address - Street 1:900 NW 10TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-7220
Practice Address - Country:US
Practice Address - Phone:405-528-3562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator