Individual
STEPHANIE CAROLINE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10450 BRIAN MOONEY AVE, EL PASO, TX 79935-2809
(915) 598-6616
Mailing address
10450 BRIAN MOONEY AVE, EL PASO, TX 79935-2809
(915) 598-6616
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215018
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227Z00000X
—
TX
Enumeration date
01/09/2019
Last updated
01/09/2019
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