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General NPI Number Information
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NPI Number | 1972681310
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Entity Type | Individual
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Provider Name | ANGELA MARIE THOMPSON LLP
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Gender | Female
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 1606 S BURDICK ST
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City | KALAMAZOO
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State | MI
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Zip | 49001-2712
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Country | US
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Telephone | 269-552-3440
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Fax | 269-552-5586
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Provider Business Mailing Address
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Address Line | 2735 S 9TH ST
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City | KALAMAZOO
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State | MI
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Zip | 49009-7939
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Country | US
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Telephone | 269-870-7757
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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 | 6301012672
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 6301012672
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License Number State | MI
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