Provider Demographics
NPI:1033351606
Name:THOMPSON, CHRISTIE JOANN
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:JOANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 UPSHAW LN
Mailing Address - Street 2:
Mailing Address - City:KEVIL
Mailing Address - State:KY
Mailing Address - Zip Code:42053-9364
Mailing Address - Country:US
Mailing Address - Phone:270-994-4819
Mailing Address - Fax:
Practice Address - Street 1:318 UPSHAW LN
Practice Address - Street 2:
Practice Address - City:KEVIL
Practice Address - State:KY
Practice Address - Zip Code:42053-9364
Practice Address - Country:US
Practice Address - Phone:270-994-4819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-29
Last Update Date:2009-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
120601OtherFIRST STEPS DEVELOPMENTAL INTERVENTIONIST