Individual
TYE CALLAN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS/L
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
0031
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031
NH RT LICENSE
NH
Enumeration date
03/01/2021
Last updated
03/01/2021
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