Provider Demographics
NPI:1194239657
Name:THOMPSON, ALTHEA A (SPECIAL EDUCATOR)
Entity type:Individual
Prefix:MISS
First Name:ALTHEA
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:SPECIAL EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 AVENUE H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-1711
Mailing Address - Country:US
Mailing Address - Phone:347-893-3059
Mailing Address - Fax:718-759-6012
Practice Address - Street 1:5501 AVENUE H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-1711
Practice Address - Country:US
Practice Address - Phone:347-893-3059
Practice Address - Fax:718-759-6012
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist