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NPI Code Detail

MEDICARE: LAUREN ASHLEY THOMPSON BA, QMHA

MEDICARE:   LAUREN ASHLEY THOMPSON  BA, QMHA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1497053631
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ASHLEY THOMPSON BA, QMHA
Provider Business Mailing Address
First Line : 6280 W TROPICAL PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-1304
Country : US
Telephone Number : 702-326-6615
Fax Number :
Provider Business Practice Location Address
First Line : 6280 W TROPICAL PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-1304
Country : US
Telephone Number : 702-326-6615
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2011
Last Update Date : 03/12/2011

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