Provider Demographics
NPI:1295031573
Name:THOMPSON, JILL ELIZABETH (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:ELIZABETH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-1629
Mailing Address - Country:US
Mailing Address - Phone:603-358-3384
Mailing Address - Fax:
Practice Address - Street 1:91 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1629
Practice Address - Country:US
Practice Address - Phone:603-358-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-02
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2085225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
256734OtherNBCOT
NH2085OtherSTATE LICENSE