Individual
JEAN MARIE THOMPSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
HSPP, MAC
Contact information
Practice address
403 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 234-0061
(574) 283-1209
Mailing address
10350 INWOOD RD, OSCEOLA, IN 46561-9392
(574) 679-4496
(574) 283-1147
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041090A
IN
Other
Enumeration date
03/20/2006
Last updated
07/08/2007
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