Provider Demographics
NPI:1790934750
Name:THOMPSON, LESLEY ANN (HHA)
Entity Type:Individual
Prefix:MRS
First Name:LESLEY
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 COLLEGE PARK DR BLDG O
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1565
Mailing Address - Country:US
Mailing Address - Phone:440-366-8889
Mailing Address - Fax:
Practice Address - Street 1:180 COLLEGE PARK DR BLDG O
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-1565
Practice Address - Country:US
Practice Address - Phone:440-366-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2846308Medicaid