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General NPI Number Information
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NPI Number | 1124372503
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Entity Type | Individual
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Provider Name | BROOKE R THOMPSON MS/LPCC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 4756 FISHBURG RD STE F
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City | DAYTON
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State | OH
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Zip | 45424-5462
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Country | US
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Telephone | 937-309-0906
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Fax | 937-365-9010
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Provider Business Mailing Address
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Address Line | PO BOX 24809
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City | DAYTON
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State | OH
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Zip | 45424-0809
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Country | US
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Telephone | 937-309-0906
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Fax | 937-365-9010
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.1100092
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License Number State | OH
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