Individual
MARISSA NICOLE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2651 TWIN OAKS CT APT 65, DECATUR, IL 62526-5836
(309) 824-6939
Mailing address
2651 TWIN OAKS CT APT 65, DECATUR, IL 62526-5836
(309) 824-6939
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
07/27/2023
Last updated
03/12/2024
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