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Individual

MRS. CASSIE NICOLE THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
778 SCOGIN DR, MONTICELLO, AR 71655-5729
(870) 460-3540
(870) 460-4860
Mailing address
778 SCOGIN DR, MONTICELLO, AR 71655-5729
(870) 460-3540
(870) 460-4860

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OTR2210
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
140897742
AR
Enumeration date
09/10/2008
Last updated
11/11/2009
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