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General NPI Number Information
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NPI Number | 1902651813
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Entity Type | Individual
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Provider Name | LAURA THOMPSON
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Gender | Female
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 516 S CREYTS RD STE F
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City | LANSING
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State | MI
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Zip | 48917-8268
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Country | US
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Telephone | 517-323-1767
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Fax |
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Provider Business Mailing Address
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Address Line | 1313 LINCOLN AVE
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City | LANSING
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State | MI
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Zip | 48910-3518
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Country | US
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Telephone | 269-274-0025
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851114829
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License Number State | MI
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