Healthcare Provider Details

I. General information

NPI: 1285572263
Provider Name (Legal Business Name): EMMA MICHELLE THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 SAINT JOHN ST APT D26
CABOT AR
72023-3157
US

IV. Provider business mailing address

16 SAINT JOHN ST APT D26
CABOT AR
72023-3157
US

V. Phone/Fax

Practice location:
  • Phone: 501-358-9377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number943529889
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: