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Individual

ANNELISE R THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1 BRANDYWINE DR, DEER PARK, NY 11729-5721
(631) 392-0081
Mailing address
72 DOGWOOD DR, WADING RIVER, NY 11792-1602
(631) 241-5659

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
P91033
NY

Other

Enumeration date
10/16/2013
Last updated
12/10/2019
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