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Individual

CARLEY ELAINE THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
215 NE 14TH ST, FORT WORTH, TX 76164-8901
(817) 814-5400
Mailing address
2800 RYAN PLACE DR, FORT WORTH, TX 76110-3127
(678) 457-6565

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
114923
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1891277331
TX
Enumeration date
08/31/2018
Last updated
08/15/2022
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