Provider Demographics
NPI:1780328765
Name:THOMAS, REGINA YOLANDA
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:YOLANDA
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 1:2625 BOWEN RD SE APT 10
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-6640
Mailing Address - Country:US
Mailing Address - Phone:202-907-8366
Mailing Address - Fax:
Practice Address - Street 1:2625 BOWEN RD SE APT 10
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6640
Practice Address - Country:US
Practice Address - Phone:202-907-8366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant