MEDICARE: YVONNE M THOMPSON SLP MS CCCSLP SPL

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
1	235Z00000X	Speech-Language Pathologist	614154	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578772398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVONNE M THOMPSON SLP MS CCCSLP SPL

Provider Business Mailing Address
First Line	:	817 WHITING AVE
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54481
Country	:	US
Telephone Number	:	715-345-5350
Fax Number	:	715-345-5966

Provider Business Practice Location Address
First Line	:	1640 WEST RIVER DRIVE
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54481
Country	:	US
Telephone Number	:	715-342-0393
Fax Number	:	715-342-0391

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	07/08/2007

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Directions to “ YVONNE M THOMPSON SLP MS CCCSLP SPL” Practice Location

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