Provider Demographics
NPI:1407487143
Name:THOMPSON, DANA LAUREN (BCBA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LAUREN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7613 STILLHAVEN CT SE
Mailing Address - Street 2:
Mailing Address - City:OWENS CROSS ROADS
Mailing Address - State:AL
Mailing Address - Zip Code:35763-3016
Mailing Address - Country:US
Mailing Address - Phone:805-405-6440
Mailing Address - Fax:
Practice Address - Street 1:7613 STILLHAVEN CT SE
Practice Address - Street 2:
Practice Address - City:OWENS CROSS ROADS
Practice Address - State:AL
Practice Address - Zip Code:35763-3016
Practice Address - Country:US
Practice Address - Phone:805-405-6440
Practice Address - Fax:256-564-7320
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-27909103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst