Healthcare Provider Details

I. General information

NPI: 1720785025
Provider Name (Legal Business Name): GABRIELLE THOMPSON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N WASHINGTON ST
JUNCTION CITY KS
66441-2906
US

IV. Provider business mailing address

2812 W 12TH AVE
EMPORIA KS
66801-6202
US

V. Phone/Fax

Practice location:
  • Phone: 785-762-3350
  • Fax:
Mailing address:
  • Phone: 620-208-7878
  • Fax: 620-208-7000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-04031
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: