Healthcare Provider Details

I. General information

NPI: 1073437810
Provider Name (Legal Business Name): TIMOYA S THOMPSON NA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 FAIRWAY DR
DEERFIELD BEACH FL
33441-1834
US

IV. Provider business mailing address

977 SPRING CIR APT 206
DEERFIELD BEACH FL
33441-7892
US

V. Phone/Fax

Practice location:
  • Phone: 954-764-9532
  • Fax:
Mailing address:
  • Phone: 860-707-8064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number161259414
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: