Provider Demographics
NPI:1699132407
Name:THOMPSON, TAMESHA MONIQUE
Entity type:Individual
Prefix:
First Name:TAMESHA
Middle Name:MONIQUE
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 1:2406C WEST ST
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-3843
Mailing Address - Country:US
Mailing Address - Phone:318-435-7715
Mailing Address - Fax:
Practice Address - Street 1:COGNITIVE DEVELOPMENT
Practice Address - Street 2:2406 C WEST STREET
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295
Practice Address - Country:US
Practice Address - Phone:318-435-7715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor