Provider Demographics
NPI:1083450423
Name:PALMER, THEA GALES (QP)
Entity type:Individual
Prefix:
First Name:THEA
Middle Name:GALES
Last Name:PALMER
Suffix:
Gender:F
Credentials:QP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 SYCAMORE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-3400
Mailing Address - Country:US
Mailing Address - Phone:919-799-9317
Mailing Address - Fax:
Practice Address - Street 1:84 SYCAMORE LAKE DR
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-3400
Practice Address - Country:US
Practice Address - Phone:919-799-9317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator