Healthcare Provider Details

I. General information

NPI: 1962332528
Provider Name (Legal Business Name): CATHERINE ANNE THOMPSON RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5154 BUCHANAN HWY
BUCHANAN GA
30113-2138
US

IV. Provider business mailing address

330 BOWDON ST
TALLAPOOSA GA
30176-1142
US

V. Phone/Fax

Practice location:
  • Phone: 404-821-2383
  • Fax:
Mailing address:
  • Phone: 404-821-2383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-286040
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: