Provider Demographics
NPI:1841024312
Name:THOMPSON, KALEAH (LMT)
Entity type:Individual
Prefix:
First Name:KALEAH
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7391 BRANDT PIKE STE C
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3274
Mailing Address - Country:US
Mailing Address - Phone:937-236-1705
Mailing Address - Fax:937-236-1735
Practice Address - Street 1:7391 BRANDT PIKE STE C
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-3274
Practice Address - Country:US
Practice Address - Phone:937-236-1705
Practice Address - Fax:937-236-1735
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.026417225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty