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NPI Code Detail

MEDICARE: REBECCA THOMPSON

MEDICARE:   REBECCA  THOMPSON
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1578275707
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA THOMPSON
Provider Business Mailing Address
First Line : 51229 CENTURY CT
Second Line :
City : WIXOM
State : MI
Zip : 48393-2074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 51229 CENTURY CT
Second Line :
City : WIXOM
State : MI
Zip : 48393-2074
Country : US
Telephone Number : 248-475-6300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2022
Last Update Date : 12/19/2022

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Directions to “ REBECCA THOMPSON ” Practice Location

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