Provider Demographics
NPI:1245590025
Name:THOMAS, LISA WADE (NC HEARING CARE SP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:WADE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NC HEARING CARE SP
Other - Prefix:PROF
Other - First Name:LISA
Other - Middle Name:WADE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NC HEARING SPECIAL
Mailing Address - Street 1:11887 SPRUCE PINE SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777
Mailing Address - Country:US
Mailing Address - Phone:828-765-6770
Mailing Address - Fax:828-765-5978
Practice Address - Street 1:11887 S. P. SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777
Practice Address - Country:US
Practice Address - Phone:828-765-6770
Practice Address - Fax:828-765-5978
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC585237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist