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Individual

MIYETTA THOMPKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
140 DARROW PL, BRONX, NY 10475-1802
(917) 504-3007
Mailing address
840 S CLUB HOUSE RD APT 1, VIRGINIA BEACH, VA 23452-6436

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary

Other

Enumeration date
02/01/2012
Last updated
09/07/2012
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