Individual
SUSANNA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC (TEMP) MHSP
Contact information
Practice address
6363 POPLAR AVE STE 404, MEMPHIS, TN 38119-4831
(901) 313-8544
Mailing address
9383 CANABRIDGE DR, LAKELAND, TN 38002-4374
(901) 687-0094
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7120
TN
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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