Individual
MRS. KHADENE OLIVENE BONNER THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 WASHINGTON ST, ROXBURY, MA 02118-3380
(857) 452-2402
(617) 986-3407
Mailing address
1640 WASHINGTON ST, ROXBURY, MA 02118-3380
(857) 452-2402
(617) 986-3407
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/01/2026
Last updated
04/01/2026
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