MEDICARE: LYDIA ACCURSIA THOMPSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula	02132025-6	DC

General Provider Information

NPI Number	:	1679371264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYDIA ACCURSIA THOMPSON

Provider Business Mailing Address
First Line	:	8010 BLAIR MILL WAY APT 1004E
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-6868
Country	:	US
Telephone Number	:	804-317-5444
Fax Number	:

Provider Business Practice Location Address
First Line	:	8010 BLAIR MILL WAY APT 1004E
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-6868
Country	:	US
Telephone Number	:	804-317-5444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2025
Last Update Date	:	03/07/2025

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