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Individual

MR. PHILLIP ANTONIO THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MFT

Contact information

Practice address
3146 W BROADWAY, LOUISVILLE, KY 40211-1441
(502) 776-0262
Mailing address
743 E BROADWAY STE 291, LOUISVILLE, KY 40202-1711
(502) 608-7640

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
06/26/2018
Last updated
06/26/2018
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