Individual
ELLEN THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 BROADHURST RD, JACKSONVILLE, NC 28540-3551
(910) 455-2211
Mailing address
200 BROADHURST RD, JACKSONVILLE, NC 28540-3551
(910) 455-2211
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6036
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7412277
—
NC
Enumeration date
11/08/2006
Last updated
06/04/2026
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