Doctor Name: | ANTOINETTE SHANELL THOMAS |
NPI Number: | 1497903462 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | AT |
License Number: | |
Business Practice Address: | 2688 State Highway 77 S Marion, AR - 723642373 |
Business Phone Number: | 8707391700 |
Business Fax Number: | 8707391752 |
Mailing Address: | 5537 Bleaux Ave, SPRINGDALE |
State: | AR |
Postal Code: | 727620737 |
Phone Number: | 4798725580 |
Fax Number: | 4798725581 |
NPI Enumeration Date: | 09/03/2008 |
NPI Last Update Date: | 09/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |