Provider Demographics
NPI:1225880552
Name:THOMPSON, TANI (MS)
Entity Type:Individual
Prefix:MRS
First Name:TANI
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:TANI
Other - Middle Name:L
Other - Last Name:BRECKENRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 JOHN KNOX RD BLDG A
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-4101
Mailing Address - Country:US
Mailing Address - Phone:850-921-0772
Mailing Address - Fax:
Practice Address - Street 1:325 JOHN KNOX RD BLDG A
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4101
Practice Address - Country:US
Practice Address - Phone:850-921-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker