Individual
TERESA MICHELE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2203 E CINNAMON WAY, FAYETTEVILLE, AR 72703-4540
(479) 244-5014
Mailing address
2203 E CINNAMON WAY, FAYETTEVILLE, AR 72703-4540
(479) 455-5014
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
161862
CA
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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