Provider Demographics
NPI:1740961093
Name:THOMPSON, MICHELLE R
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:R
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4198 RIDGECLIFF DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45440-3318
Mailing Address - Country:US
Mailing Address - Phone:937-304-3244
Mailing Address - Fax:
Practice Address - Street 1:4198 RIDGECLIFF DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-3318
Practice Address - Country:US
Practice Address - Phone:937-304-3244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management