Provider Demographics
NPI:1710195565
Name:THOMPSON, MORGAN B (COTA)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:B
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8102 SHELDON RD
Mailing Address - Street 2:1604
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1602
Mailing Address - Country:US
Mailing Address - Phone:813-892-8271
Mailing Address - Fax:
Practice Address - Street 1:8102 SHELDON RD
Practice Address - Street 2:1604
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1602
Practice Address - Country:US
Practice Address - Phone:813-892-8271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9932224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant