Provider Demographics
NPI:1881042877
Name:THOMPSON, HELEN ANN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:ANN
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:PO BOX 1138
Mailing Address - Street 2:
Mailing Address - City:ADELANTO
Mailing Address - State:CA
Mailing Address - Zip Code:92301-1138
Mailing Address - Country:US
Mailing Address - Phone:760-246-0010
Mailing Address - Fax:
Practice Address - Street 1:1311 E. STATE ST.
Practice Address - Street 2:
Practice Address - City:SAN BERNARDO
Practice Address - State:CA
Practice Address - Zip Code:92404
Practice Address - Country:US
Practice Address - Phone:888-830-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12135830235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist