Individual
MISS AMY LYNN THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L, M.S CF-SLP
Contact information
Practice address
201 W CLAY ST, COLLINSVILLE, IL 62234-3219
(618) 346-6311
Mailing address
5673 OLD ALTON EDWARDSVILLE RD, EDWARDSVILLE, IL 62025-7219
(618) 978-3792
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057001699
IL
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/02/2013
Last updated
10/03/2018
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