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Organization

OMAR THOMPSON ORAL THOMPSON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OMAR THOMPSON (MENTOR)
(617) 785-9459
Entity
Organization

Contact information

Practice address
20 GOODALE RD APT 2, BOSTON, MA 02126-1788
(617) 785-9459
Mailing address
20 GOODALE RD APT 2, BOSTON, MA 02126-1788
(617) 785-9459

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary

Other

Enumeration date
11/22/2019
Last updated
11/22/2019
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