Provider Demographics
NPI:1609101815
Name:THOMPSON, CHRISTEL (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTEL
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 MCLEAN CT
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-8110
Mailing Address - Country:US
Mailing Address - Phone:276-970-4664
Mailing Address - Fax:
Practice Address - Street 1:3002 MCLEAN CT
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-8110
Practice Address - Country:US
Practice Address - Phone:276-970-4664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006264235Z00000X
WV1158235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist