Provider Demographics
NPI:1992156939
Name:THOMPSON EARLY LANGUAGE AND AUTISM INTERVENTION, LLC
Entity type:Organization
Organization Name:THOMPSON EARLY LANGUAGE AND AUTISM INTERVENTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGAUGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:319-382-2807
Mailing Address - Street 1:PO BOX 114
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-0016
Mailing Address - Country:US
Mailing Address - Phone:319-382-2807
Mailing Address - Fax:
Practice Address - Street 1:7521 POPLAR LN
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-9438
Practice Address - Country:US
Practice Address - Phone:319-382-2807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty