Healthcare Provider Details

I. General information

NPI: 1487735981
Provider Name (Legal Business Name): MRS. ASTER KIFLE THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 LIME CIRCLE
HENDERSON NV
89015
US

IV. Provider business mailing address

380 LIME CIRCLE
HENDERSON NV
89015
US

V. Phone/Fax

Practice location:
  • Phone: 831-224-3523
  • Fax:
Mailing address:
  • Phone: 831-224-3523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: