Doctor Name: | MS. SHIRLEY MARY THOMPSON |
NPI Number: | 1053556514 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED |
License Number: | 4811 |
Business Practice Address: | 161 Landmark Dr Taylors, SC - 296872819 |
Business Phone Number: | 8644236850 |
Business Fax Number: | |
Mailing Address: | 4 Poplar Springs Dr, MAULDIN |
State: | SC |
Postal Code: | 296623192 |
Phone Number: | 8644236850 |
Fax Number: | |
NPI Enumeration Date: | 12/11/2008 |
NPI Last Update Date: | 12/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4811 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |