MEDICARE: FIONA JANE THOMPSON M.S. CCC-SLP

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	031852	NY

General Provider Information

NPI Number	:	1629780366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FIONA JANE THOMPSON M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	451 RUDY CHASE DR APT 1108
Second Line	:
City	:	GLENVILLE
State	:	NY
Zip	:	12302-7130
Country	:	US
Telephone Number	:	518-526-8496
Fax Number	:

Provider Business Practice Location Address
First Line	:	432 WESTERN AVE
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12203-1400
Country	:	US
Telephone Number	:	518-337-4914
Fax Number	:

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

Provider Enumeration Date	:	12/14/2022
Last Update Date	:	01/03/2023

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Directions to “ FIONA JANE THOMPSON M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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