Provider Demographics
NPI:1528778255
Name:THOMPSON, ZIERRAH LEA
Entity type:Individual
Prefix:
First Name:ZIERRAH
Middle Name:LEA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10340 MIDLAND RD LOT 69
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-9715
Mailing Address - Country:US
Mailing Address - Phone:989-209-7406
Mailing Address - Fax:
Practice Address - Street 1:5039 VILLA LINDE PKWY STE 30
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3450
Practice Address - Country:US
Practice Address - Phone:989-401-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician