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NPI Code Detail

MEDICARE: ALIYAH RAE THOMPSON

MEDICARE: ALIYAH RAE 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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1689278582
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALIYAH RAE THOMPSON
Provider Business Mailing Address
First Line : 445 E DUBLIN GRANVILLE RD
Second Line :
City : WORTHINGTON
State : OH
Zip : 43085-3192
Country : US
Telephone Number : 614-436-8396
Fax Number :
Provider Business Practice Location Address
First Line : 22 N 1ST ST
Second Line :
City : NEWARK
State : OH
Zip : 43055-5608
Country : US
Telephone Number : 740-334-4056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 12/31/2024

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Directions to “ ALIYAH RAE THOMPSON ” Practice Location

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