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Individual

MICHELLE MARIE THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1729 2ND ST, RADFORD, VA 24141-1218
(540) 761-6108
Mailing address
1729 2ND ST, RADFORD, VA 24141-1218
(540) 761-6108

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000464
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0131000464
VIRGINIA BOARD OF PROFESSIONAL SERVICES
VA
Enumeration date
08/25/2015
Last updated
04/12/2023
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