Individual
RONALD TYLER THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
57 KENILWORTH DR E, STAMFORD, CT 06902
(203) 912-1795
Mailing address
57 KENILWORTH DR E, STAMFORD, CT 06902
(203) 912-1795
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
004373
CT
225X00000X
Occupational Therapist
Primary
019439
NY
Other
Enumeration date
09/14/2015
Last updated
03/02/2017
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