Individual
MR. J. GRAHAM THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1020 S 5TH ST, SPRINGFIELD, IL 62703-2312
(217) 544-3143
(217) 544-4436
Mailing address
1020 S 5TH ST, SPRINGFIELD, IL 62703-2312
(217) 544-3143
(217) 544-4436
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166-000115
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
166-000115
MARRIAGE & FAMILY THERAPI
IL
Enumeration date
11/28/2006
Last updated
04/16/2009
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