Individual
TAYANNA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3272 N 30TH ST, MILWAUKEE, WI 53216-3822
(414) 241-2951
Mailing address
3272 N 30TH ST, MILWAUKEE, WI 53216-3822
(414) 241-2951
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
T5128178760409
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T5128178760409
IDENTIFICATION NUMBER
WI
Enumeration date
04/27/2021
Last updated
04/27/2021
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