Provider Demographics
NPI:1588470181
Name:THOMAS, NEYSA (MS)
Entity type:Individual
Prefix:
First Name:NEYSA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 PALM CREST DR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-2003
Mailing Address - Country:US
Mailing Address - Phone:301-706-6889
Mailing Address - Fax:717-496-0346
Practice Address - Street 1:130 S PENN ST STE 201
Practice Address - Street 2:
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-1901
Practice Address - Country:US
Practice Address - Phone:717-477-2556
Practice Address - Fax:717-496-0346
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health