Provider Demographics
NPI:1720431679
Name:THOMPSON, BILLY CHRISTOPHER (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:CHRISTOPHER
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 PEACE CREEK TRCE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4348
Mailing Address - Country:US
Mailing Address - Phone:706-340-8839
Mailing Address - Fax:
Practice Address - Street 1:650 PEACE CREEK TRCE
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4348
Practice Address - Country:US
Practice Address - Phone:706-340-8839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP008347235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist