| Doctor Name: | JESSICA THOMAS |
| NPI Number: | 1073801098 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CCC-SLP |
| License Number: | 3389 |
| Business Practice Address: | 4501 Main St Suite 5 Shallotte, NC - 284704589 |
| Business Phone Number: | 9106121002 |
| Business Fax Number: | 9107555864 |
| Mailing Address: | 1176 Woodbridge Ln Se, BOLIVIA |
| State: | NC |
| Postal Code: | 284228969 |
| Phone Number: | 9106121002 |
| Fax Number: | 9107555864 |
| NPI Enumeration Date: | 07/11/2011 |
| NPI Last Update Date: | 01/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 3389 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |