Individual
MR. BRUCE TODD THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4815 GERONA DR, AUSTIN, TX 78759-4914
(512) 228-8847
Mailing address
4815 GERONA DR, AUSTIN, TX 78759-4914
(512) 228-8847
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01194
TX
Other
Enumeration date
07/13/2009
Last updated
07/13/2009
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