Provider Demographics
NPI:1992690762
Name:THOMPSON, CHRISTINA M (NBCHWC, BCTMB)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:NBCHWC, BCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2984 TRIVERTON PIKE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-5841
Mailing Address - Country:US
Mailing Address - Phone:608-416-5446
Mailing Address - Fax:
Practice Address - Street 1:2984 TRIVERTON PIKE DR STE 203
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-5841
Practice Address - Country:US
Practice Address - Phone:608-416-5446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3777-146225700000X
WIA-3279653171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist