Individual
MRS. MYSTIC MICHELLE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3223 E BROADWAY ST, NORTH LITTLE ROCK, AR 72114-6344
(501) 945-5544
(501) 945-5546
Mailing address
3223 E BROADWAY ST, NORTH LITTLE ROCK, AR 72114-6344
(501) 945-5544
(501) 945-5546
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R67979
AR
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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