Doctor Name: | GYNNA ELISE THOMPSON |
NPI Number: | 1013127844 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SLP |
License Number: | 1056 |
Business Practice Address: | 310 2nd Ave Sw Miami, OK - 743546743 |
Business Phone Number: | 9185407736 |
Business Fax Number: | |
Mailing Address: | 901 E 10th St, GROVE |
State: | OK |
Postal Code: | 743442969 |
Phone Number: | 9187879841 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1056 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |