Individual
MS. SANDRA FAYE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCASA
Contact information
Practice address
99 RAVENS NEST LN, CAMERON, NC 28326-6624
(516) 457-7066
Mailing address
99 RAVENS NEST LN, CAMERON, NC 28326-6624
(516) 457-7066
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20271
NC
104100000X
Social Worker
072930
NY
Other
Enumeration date
02/02/2012
Last updated
01/11/2016
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