Doctor Name: | MS. LAURETTA A THOMPSON |
NPI Number: | 1619258746 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 0019006433 |
Business Practice Address: | 8550 Arlington Blvd Suite 325 Roselle Center For Healing Fairfax, VA - 22031 |
Business Phone Number: | 7036987117 |
Business Fax Number: | 7036985729 |
Mailing Address: | 8550 Arlington Blvd Suite 325, Roselle Center For Healing FAIRFAX |
State: | VA |
Postal Code: | 22031 |
Phone Number: | 7036987117 |
Fax Number: | 7036985729 |
NPI Enumeration Date: | 09/02/2011 |
NPI Last Update Date: | 09/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 0019006433 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |