Individual
ANNIE ELIZA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
590 POPLAR FORK RD, HURRICANE, WV 25526-9434
(304) 757-7826
Mailing address
409 BELLEFONTE RD, ASHLAND, KY 41102-2311
(606) 923-9424
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1755
WV
Other
Enumeration date
07/03/2010
Last updated
07/03/2010
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