Provider Demographics
NPI:1992015416
Name:THOMAS, ASHLEY PATRICE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:PATRICE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 FOXWORTH DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MS
Mailing Address - Zip Code:39429-8269
Mailing Address - Country:US
Mailing Address - Phone:972-741-7500
Mailing Address - Fax:601-444-5036
Practice Address - Street 1:103 FOXWORTH DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MS
Practice Address - Zip Code:39429-8269
Practice Address - Country:US
Practice Address - Phone:972-741-7500
Practice Address - Fax:601-444-5036
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3425235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist