Individual
MISS CHIQUITA NICOLE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.T.
Contact information
Practice address
256 GREEN ST, PARK FOREST, IL 60466-1610
(708) 747-0447
Mailing address
256 GREEN ST, PARK FOREST, IL 60466-1213
(708) 747-0447
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
05/29/2012
Last updated
05/29/2012
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