Provider Demographics
NPI:1336450170
Name:THOMAS, DENYESE ALLYSON
Entity Type:Individual
Prefix:
First Name:DENYESE
Middle Name:ALLYSON
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 1:2020 12TH ST NW
Mailing Address - Street 2:UNIT T02
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-7573
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2020 12TH ST NW
Practice Address - Street 2:UNIT T02
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-7573
Practice Address - Country:US
Practice Address - Phone:301-437-5142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-26
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP000263235Z00000X
MD03446235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD03446OtherDEPARTMENTAL OF HEALTH AND MENTAL HYGIENE
12013571OtherAMERICAN SPEECH AND LANGUAGE ASSOCIATION
DCSLP000263OtherGOVERNMENT OF THE DISTRICT OF COLUMBIA-SPEECH-LANGUAGE PATHOLOGIST