Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 1240 | AL |
NPI | 1073764098 |
---|---|
Provider Name | Dr. David Alan Thompson |
First Address | Chattanooga, TN 37421-1289 |
Second Address | Eglin Afb, FL 32542-1391 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2008 |
Last Update Date | 13/07/2016 |