Provider Demographics
NPI:1366431298
Name:THOMPSON, SUSAN ELAINE (MS)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELAINE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 E STATE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4354
Mailing Address - Country:US
Mailing Address - Phone:614-566-8633
Mailing Address - Fax:614-566-8008
Practice Address - Street 1:285 E STATE ST
Practice Address - Street 2:SUITE 400
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4354
Practice Address - Country:US
Practice Address - Phone:614-566-8633
Practice Address - Fax:614-566-8008
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS