Provider Demographics
NPI:1538056627
Name:THOMPSON, SHEMARIAH MATTITHYAH
Entity type:Individual
Prefix:MS
First Name:SHEMARIAH
Middle Name:MATTITHYAH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 S BEACH CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-6744
Mailing Address - Country:US
Mailing Address - Phone:407-547-0925
Mailing Address - Fax:
Practice Address - Street 1:1173 S BEACH CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-6744
Practice Address - Country:US
Practice Address - Phone:407-547-0925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services