Provider Demographics
NPI:1457966954
Name:THAMES, NAHBILA SONIA (LMT)
Entity Type:Individual
Prefix:
First Name:NAHBILA
Middle Name:SONIA
Last Name:THAMES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 FRESHMAN DR # 432
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-5434
Mailing Address - Country:US
Mailing Address - Phone:205-529-0164
Mailing Address - Fax:205-000-0000
Practice Address - Street 1:4765 HWY 78 STE C
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-4691
Practice Address - Country:US
Practice Address - Phone:404-454-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011309225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty