Individual
GINA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2820 WATERFORD LAKE DR STE 102, MIDLOTHIAN, VA 23112-3994
(804) 895-4678
Mailing address
3433 BRAMBLETON AVE STE 201A, ROANOKE, VA 24018-6527
(540) 291-7480
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-17639
VA
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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