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Individual
SUSAN THOMPSON
Active
Individual
SUSAN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,LCPC,ATR
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180000932
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001634445
BCBSIL
—
01
—
103637507
UBH
—
Enumeration date
12/04/2007
Last updated
12/10/2012
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