Individual
DANIELLE L JENKINS THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
921 14TH AVE, LONGVIEW, WA 98632-2316
(360) 423-0203
Mailing address
5050 COLUMBIA HEIGHTS RD, LONGVIEW, WA 98632-9537
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
RC00056809
WA
Other
Enumeration date
04/20/2009
Last updated
04/20/2009
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