| Doctor Name: | DR. NANCY JACKSON THOMAS |
| NPI Number: | 1750467833 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | PY0003951 |
| Business Practice Address: | 13000 Sawgrass Village Cir Ste 11 Ponte Vedra, FL - 320823078 |
| Business Phone Number: | 9042808555 |
| Business Fax Number: | 9042808562 |
| Mailing Address: | 4650 Swilcan Bridge Ln S, JACKSONVILLE |
| State: | FL |
| Postal Code: | 322245620 |
| Phone Number: | 9042808555 |
| Fax Number: | 9042808562 |
| NPI Enumeration Date: | 10/31/2006 |
| NPI Last Update Date: | 08/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY0003951 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |