Individual
SUSAN T THOMPSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1381 S PATRICK DR, 45TH MEDICAL GROUP, PATRICK AFB, FL 32925-3606
(321) 494-8234
(321) 494-1378
Mailing address
6562 FAWN RIDGE DR, VIERA, FL 32940-6859
(321) 255-0743
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801083539
MI
Other
Enumeration date
09/13/2005
Last updated
07/08/2007
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