Individual
DR. JERRY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
263 ROYAL OAK WAY, VENICE, FL 34292-3189
(941) 685-7228
Mailing address
263 ROYAL OAK WAY, VENICE, FL 34292-3189
(941) 685-7228
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY5807
FL
103TC0700X
Clinical Psychologist
PY0005807
FL
Other
Enumeration date
02/03/2015
Last updated
04/19/2019
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