Provider Demographics
NPI:1104097971
Name:MIRABELLE-THOMPSON, JOAN E (LMT)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:E
Last Name:MIRABELLE-THOMPSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:JOAN
Other - Middle Name:E
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:168 PLAISTOW RD
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2897
Mailing Address - Country:US
Mailing Address - Phone:603-382-8565
Mailing Address - Fax:603-974-0887
Practice Address - Street 1:168 PLAISTOW RD
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2897
Practice Address - Country:US
Practice Address - Phone:603-382-8565
Practice Address - Fax:603-974-0887
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2519M174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist