Provider Demographics
NPI:1811385503
Name:TOMPKINS, MICHELLE IRENE (MA)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:IRENE
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2284 ASHLEY RIVER RD
Mailing Address - Street 2:APT 417
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-4700
Mailing Address - Country:US
Mailing Address - Phone:757-652-8815
Mailing Address - Fax:
Practice Address - Street 1:2284 ASHLEY RIVER RD
Practice Address - Street 2:APT 417
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-4700
Practice Address - Country:US
Practice Address - Phone:757-652-8815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional