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General NPI Number Information
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NPI Number | 1750435376
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Entity Type | Individual
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Provider Name | LAURA THOMPSON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 7777 GLADES RD STE 100
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City | BOCA RATON
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State | FL
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Zip | 33434-4150
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Country | US
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Telephone | 561-989-4133
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Fax |
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Provider Business Mailing Address
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Address Line | 8145 TUMBLESTONE CT APT 1214
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City | DELRAY BEACH
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State | FL
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Zip | 33446-4457
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Country | US
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Telephone | 561-989-4133
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 012802
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY003127
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY9723
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License Number State | FL
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