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NPI Code Detail

MEDICARE: MRS. DE'ASIA LANEE THOMPSON LISW-S

MEDICARE: MRS. DE'ASIA LANEE THOMPSON LISW-S
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
11041C0700XClinical Social WorkerS.1101268OH
21041C0700XClinical Social WorkerI.1700459-SUPVOH

General Provider Information

NPI Number : 1932581527
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DE'ASIA LANEE THOMPSON LISW-S
Provider Business Mailing Address
First Line : 7031 CORPORATE WAY STE 103
Second Line :
City : DAYTON
State : OH
Zip : 45459-4262
Country : US
Telephone Number : 937-619-9089
Fax Number : 937-265-6028
Provider Business Practice Location Address
First Line : 7031 CORPORATE WAY STE 103
Second Line :
City : DAYTON
State : OH
Zip : 45459-4262
Country : US
Telephone Number : 937-619-6089
Fax Number : 937-265-6028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2015
Last Update Date : 06/11/2024

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Directions to “ MRS. DE'ASIA LANEE THOMPSON LISW-S” Practice Location

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