Provider Demographics
NPI:1346410743
Name:THOMPSON, STEVEN W (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:W
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 LINCOLN COURT AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-1813
Mailing Address - Country:US
Mailing Address - Phone:770-241-8896
Mailing Address - Fax:
Practice Address - Street 1:126 LINCOLN COURT AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-1813
Practice Address - Country:US
Practice Address - Phone:770-241-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT 3865225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist