Individual
MS. MANDISA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST STE 200, FOREST HILLS, NY 11375-4739
(718) 762-7633
Mailing address
952 E 87TH ST, BROOKLYN, NY 11236-3909
(646) 548-7290
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
115642001
NY
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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