Provider Demographics
NPI:1861661464
Name:THOMPSON, KAREN RENE' (CTRS, HTR)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:RENE'
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CTRS, HTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 S ASHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-9763
Mailing Address - Country:US
Mailing Address - Phone:812-219-1526
Mailing Address - Fax:
Practice Address - Street 1:3415 S ASHWOOD DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-9763
Practice Address - Country:US
Practice Address - Phone:812-219-1526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist