Individual
LATRESE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14419 ASHDALE WAY, CHESTERFIELD, VA 23832-2414
(804) 292-9048
Mailing address
14419 ASHDALE WAY, CHESTERFIELD, VA 23832-2414
(804) 292-9048
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
03/01/2025
Last updated
03/01/2025
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