Provider Demographics
NPI:1134421431
Name:THOMAS, DONALD LEE (REHAB SPECIALIST)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:LEE
Last Name:THOMAS
Suffix:
Gender:M
Credentials:REHAB SPECIALIST
Other - Prefix:MR
Other - First Name:DONALD
Other - Middle Name:LEE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REHAB SPECIALIST
Mailing Address - Street 1:809 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:OKEMAH
Mailing Address - State:OK
Mailing Address - Zip Code:74859-2213
Mailing Address - Country:US
Mailing Address - Phone:918-520-2370
Mailing Address - Fax:
Practice Address - Street 1:809 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:OKEMAH
Practice Address - State:OK
Practice Address - Zip Code:74859-2213
Practice Address - Country:US
Practice Address - Phone:918-520-2370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health