Provider Demographics
NPI:1093017493
Name:THOMPSON, JOANN T (SLP)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:T
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 E 242ND ST
Mailing Address - Street 2:2F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-1263
Mailing Address - Country:US
Mailing Address - Phone:347-331-3397
Mailing Address - Fax:
Practice Address - Street 1:698 YONKERS AVE
Practice Address - Street 2:1J
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-2689
Practice Address - Country:US
Practice Address - Phone:914-969-3016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020576-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist