Provider Demographics
NPI:1912280223
Name:THOMPSON, TAMMY ANNETTE (MSOTR/L)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:ANNETTE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-7522
Mailing Address - Country:US
Mailing Address - Phone:417-388-0905
Mailing Address - Fax:
Practice Address - Street 1:2617 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-7522
Practice Address - Country:US
Practice Address - Phone:417-388-0905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007031186225X00000X
OK1517225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist