Doctor Name: | LAURA THOMPSON |
NPI Number: | 1760873772 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LAC |
License Number: | 37AC00239000 |
Business Practice Address: | 40 Deck St Barnegat, NJ - 080051844 |
Business Phone Number: | 6093123417 |
Business Fax Number: | |
Mailing Address: | 40 Deck St, BARNEGAT |
State: | NJ |
Postal Code: | 080051844 |
Phone Number: | 6093123417 |
Fax Number: | |
NPI Enumeration Date: | 02/12/2015 |
NPI Last Update Date: | 02/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 37AC00239000 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |