Provider Demographics
NPI:1053916957
Name:THOMAS, MYA ALYSSA
Entity type:Individual
Prefix:
First Name:MYA
Middle Name:ALYSSA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 VILLAGE OF SEARIGHTS
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-9019
Mailing Address - Country:US
Mailing Address - Phone:724-812-1265
Mailing Address - Fax:304-363-7376
Practice Address - Street 1:503 MORGANTOWN AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-4388
Practice Address - Country:US
Practice Address - Phone:303-363-7375
Practice Address - Fax:304-363-7376
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker