Provider Demographics
NPI:1962753814
Name:THOMPSON, COLLEEN MARIE (MSED)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 MOORE ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NY
Mailing Address - Zip Code:14411-1152
Mailing Address - Country:US
Mailing Address - Phone:585-331-7304
Mailing Address - Fax:
Practice Address - Street 1:535 MOORE ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NY
Practice Address - Zip Code:14411-1152
Practice Address - Country:US
Practice Address - Phone:585-331-7304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist