Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP1600X | Pastoral Counselor | ||
N | 103K00000X | Behavior Analyst |
NPI | 1043810450 |
---|---|
Provider Name | Dr. Donnette Dawn Thomas |
First Address | Rock Hill, SC 29730-5384 |
Second Address | Rock Hill, SC 29730-5384 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2020 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GP9563 | (05) | SC |