Provider Demographics
NPI:1326581265
Name:THOMPSON, SUSAN PATRICIA (MA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:PATRICIA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 N VIRGINIA ST
Mailing Address - Street 2:DEPARTMENT OF PSYCHOLOGY 0296
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89557-0296
Mailing Address - Country:US
Mailing Address - Phone:775-784-6828
Mailing Address - Fax:775-784-1126
Practice Address - Street 1:1664 N VIRGINIA ST
Practice Address - Street 2:DEPARTMENT OF PSYCHOLOGY 0296
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-0296
Practice Address - Country:US
Practice Address - Phone:775-784-6828
Practice Address - Fax:775-784-1126
Is Sole Proprietor?:No
Enumeration Date:2016-11-26
Last Update Date:2016-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program