Provider Demographics
NPI:1922100494
Name:THOMPSON, KATHERINE SUE (FOSTER PARENT)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:SUE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FOSTER PARENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 S 124TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74129-8238
Mailing Address - Country:US
Mailing Address - Phone:918-437-9120
Mailing Address - Fax:
Practice Address - Street 1:2812 S 124TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74129-8238
Practice Address - Country:US
Practice Address - Phone:918-437-9120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging