Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 70639 | TX |
Y | 101YP2500X | Professional Counselor | LPC-1357 | WY |
N | 101YP2500X | Professional Counselor | LPC005983 | GA |
NPI | 1003122797 |
---|---|
Provider Name | Lorraine Thompson |
First Address | Jackson, WY 83001-2019 |
Second Address | Jackson, WY 83001-8599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2010 |
Last Update Date | 23/06/2020 |