Individual
MRS. AMY SUZANNE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED DIETITIAN
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01002584
HEALTH PLUS OF MICHIGAN
MI
01
—
0D40051
BCBSM PIN
MI
Enumeration date
01/05/2007
Last updated
09/30/2010
Update your record
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