Provider Demographics
NPI:1033260393
Name:THOMPSON, NANCY ELIZABETH (OT)
Entity Type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:ELIZABETH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 CAPE COD TER
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-3022
Mailing Address - Country:US
Mailing Address - Phone:561-254-6448
Mailing Address - Fax:561-684-3791
Practice Address - Street 1:1030 CAPE COD TER
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-3022
Practice Address - Country:US
Practice Address - Phone:561-254-6448
Practice Address - Fax:561-684-3791
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT5319225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT5319OtherPROFESSIONAL LICENSE