Individual
TYESHA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
39 PROSPECT ST, BROCKTON, MA 02301-2749
(508) 405-5696
Mailing address
39 PROSPECT ST, BROCKTON, MA 02301-2749
(508) 405-5696
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/09/2019
Last updated
03/09/2019
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