Provider Demographics
NPI:1568920866
Name:THOMPSON, EMILY (OTR/ L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
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 1:4846 W CLINTON CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-9103
Mailing Address - Country:US
Mailing Address - Phone:608-434-8151
Mailing Address - Fax:
Practice Address - Street 1:897 N M ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2017
Practice Address - Country:US
Practice Address - Phone:559-687-1340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19398225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist