Provider Demographics
NPI:1265755185
Name:THOMPSON, YVETTE TOLA (PSYD)
Entity type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:TOLA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 ROCK RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2320
Mailing Address - Country:US
Mailing Address - Phone:203-244-5200
Mailing Address - Fax:203-244-5200
Practice Address - Street 1:62 ROCK RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-2320
Practice Address - Country:US
Practice Address - Phone:203-244-5200
Practice Address - Fax:203-244-5200
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015919103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist