Individual
MARIAH ANNE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT-IT
Contact information
Practice address
11447 2ND ST STE 9B, ROSCOE, IL 61073-9522
(815) 601-4673
(866) 303-8062
Mailing address
11447 2ND ST STE 9B, ROSCOE, IL 61073-9522
(815) 601-4673
(866) 303-8062
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
812-228
WI
Other
Enumeration date
06/03/2020
Last updated
11/01/2023
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