Provider Demographics
NPI:1043781768
Name:THOMPSON, VIVIENNE FRANCES (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:VIVIENNE
Middle Name:FRANCES
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 N BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-1035
Mailing Address - Country:US
Mailing Address - Phone:443-223-8917
Mailing Address - Fax:
Practice Address - Street 1:140 STEPNEY LN
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2801
Practice Address - Country:US
Practice Address - Phone:410-956-5885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist