Doctor Name: | PAMELA THOMPSON |
NPI Number: | 1235505371 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 4059 |
Business Practice Address: | 204 N Main St Springhill, LA - 710753248 |
Business Phone Number: | 3187034141 |
Business Fax Number: | 3185393733 |
Mailing Address: | Po Box 78776, SHREVEPORT |
State: | LA |
Postal Code: | 711378776 |
Phone Number: | 3187034141 |
Fax Number: | 3185393733 |
NPI Enumeration Date: | 08/12/2015 |
NPI Last Update Date: | 08/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4059 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |