Provider Demographics
NPI:1629780366
Name:THOMPSON, FIONA JANE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:FIONA
Middle Name:JANE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 RUDY CHASE DR APT 1108
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12302-7130
Mailing Address - Country:US
Mailing Address - Phone:518-526-8496
Mailing Address - Fax:
Practice Address - Street 1:432 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1400
Practice Address - Country:US
Practice Address - Phone:518-337-4914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist