Doctor Name: | MICHAEL S THOMPSON |
NPI Number: | 1164733994 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPCI |
License Number: | 6212908-3904 |
Business Practice Address: | 71 N 490 W American Fork, UT - 840032264 |
Business Phone Number: | 8017637775 |
Business Fax Number: | 8017637651 |
Mailing Address: | 71 N 490 W, AMERICAN FORK |
State: | UT |
Postal Code: | 840032264 |
Phone Number: | 8017637775 |
Fax Number: | 8017637651 |
NPI Enumeration Date: | 06/26/2010 |
NPI Last Update Date: | 06/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6212908-3904 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |