Provider Demographics
NPI:1134902158
Name:THOMAS, CAROLYN MELISSA
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MELISSA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:MELISSA
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:104 JAVIT CT
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2439
Mailing Address - Country:US
Mailing Address - Phone:330-207-4372
Mailing Address - Fax:
Practice Address - Street 1:104 JAVIT CT
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2439
Practice Address - Country:US
Practice Address - Phone:330-207-4372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator