Provider Demographics
NPI:1093906158
Name:THOMPSON, JOHN PAUL (MS CCC/SLP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PAUL
Last Name:THOMPSON
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Gender:M
Credentials:MS CCC/SLP
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Mailing Address - Street 1:920 FREDERICA ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-3050
Mailing Address - Country:US
Mailing Address - Phone:270-688-8055
Mailing Address - Fax:270-688-8073
Practice Address - Street 1:920 FREDERICA ST
Practice Address - Street 2:SUITE 203
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-3050
Practice Address - Country:US
Practice Address - Phone:270-688-8055
Practice Address - Fax:270-688-8073
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY1804235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist