Individual
TIERRA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3403 WOODSTOCK ST, PORTSMOUTH, VA 23701-3559
(757) 227-1663
Mailing address
3403 WOODSTOCK ST, PORTSMOUTH, VA 23701-3559
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
342000000X
Transportation Network Company
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
01/30/2024
Last updated
02/01/2024
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