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General NPI Number Information
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NPI Number | 1134834237
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Entity Type | Individual
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Provider Name | JENNIFER THOMPSON
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Gender | Female
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 1051 BRIGHTSEAT RD
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City | LANDOVER
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State | MD
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Zip | 20785-3738
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Country | US
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Telephone | 240-487-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 4TH ST SE APT 634
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City | WASHINGTON
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State | DC
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Zip | 20003-3496
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Country | US
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Telephone |
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 09891
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License Number State | MD
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