Provider Demographics
NPI:1336421825
Name:THOMPKINS, AISHAH D (MS, BCBA)
Entity type:Individual
Prefix:
First Name:AISHAH
Middle Name:D
Last Name:THOMPKINS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 N PEARL LAKE CSWY UNIT 212
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2949
Mailing Address - Country:US
Mailing Address - Phone:786-267-4079
Mailing Address - Fax:
Practice Address - Street 1:1800 PEMBROKE DRIVE SUITE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810
Practice Address - Country:US
Practice Address - Phone:786-267-4079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst