Provider Demographics
NPI:1336912179
Name:THOMPSON, DEKAY (BCBA)
Entity Type:Individual
Prefix:
First Name:DEKAY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 SPRINGBROOK TRL N
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-4003
Mailing Address - Country:US
Mailing Address - Phone:509-995-5710
Mailing Address - Fax:
Practice Address - Street 1:540 SPRINGBROOK TRL N
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-4003
Practice Address - Country:US
Practice Address - Phone:509-995-5710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty