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General NPI Number Information
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NPI Number | 1447635313
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Entity Type | Individual
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Provider Name | COLLEEN MARIE THOMPSON LMFT 86224
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Gender | Female
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Dates
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Enumeration Date | 07/21/2015
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Last Update Date | 07/21/2015
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Provider Practice Location Address
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Address Line | 777 LOMA VISTA DR
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City | REDDING
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State | CA
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Zip | 96002-3113
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Country | US
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Telephone | 530-221-5683
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Fax | 530-221-0267
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Provider Business Mailing Address
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Address Line | PO BOX 325
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City | LEWISTON
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State | CA
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Zip | 96052-0325
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Country | US
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Telephone | 707-834-3437
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Fax | 530-221-0267
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 86224
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License Number State | CA
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