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1306462205
JELISA RENAE THOMAS
CENTRALIA, WA
NPI
1306462205
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2020-06-17
Last Update Date
2020-06-17
Business Address
JELISA RENAE THOMAS
3510 STEELHAMMER LN
CENTRALIA, WA 98531
Phone number: 360-623-8020
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Mailing Address
JELISA RENAE THOMAS
2428 W REYNOLDS AVE
CENTRALIA, WA 98531-4554
Phone number: 360-330-9044
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