Provider Demographics
NPI:1215274691
Name:THOMAS, JAUNELLE (MS,ED)
Entity type:Individual
Prefix:MS
First Name:JAUNELLE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS,ED
Other - Prefix:MS
Other - First Name:JAUNELLE
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,ED
Mailing Address - Street 1:1144 E 224TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-5835
Mailing Address - Country:US
Mailing Address - Phone:347-373-8306
Mailing Address - Fax:
Practice Address - Street 1:1022 E 228TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466
Practice Address - Country:US
Practice Address - Phone:347-373-8306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-06
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst