Basic Information
| Provider Information | |||||||||
| NPI: | 1710230990 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | RANEY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | B.S., BCABA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3700 CAPITAL CIR SE APT 409 | ||||||||
| Address2: | |||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323112705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9047040315 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1406 HAYS ST STE 8 | ||||||||
| Address2: | |||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323012843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8505210242 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2012 | ||||||||
| LastUpdateDate: | 10/24/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 0-12-5183 | FL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.