Individual
WILLA M THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
202 POMFRET ST, PUTNAM, CT 06260-1833
(860) 963-7917
(860) 963-0015
Mailing address
40 MANSFIELD AVE, WILLIMANTIC, CT 06226-2018
(504) 247-3796
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7431
CT
Other
Enumeration date
11/09/2017
Last updated
01/22/2018
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