Provider Demographics
NPI:1730359746
Name:THOMAS, CAROLYN MARIE (MSW)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:MARIE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 4 E- 6 VILLA COOPERATIVA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-0000
Mailing Address - Country:US
Mailing Address - Phone:787-594-6352
Mailing Address - Fax:
Practice Address - Street 1:CALLE 4 E- 6 VILLA COOPERATIVA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-0000
Practice Address - Country:US
Practice Address - Phone:787-594-6352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR94991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical