Individual
JACLYN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
224 LEAVENWORTH RD, SHELTON, CT 06484-1881
(203) 926-1206
(203) 926-0413
Mailing address
67 MAPLE AVE, DERBY, CT 06418-1328
(203) 732-1330
(203) 732-1332
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002923
CT
Other
Enumeration date
07/10/2013
Last updated
02/19/2020
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