Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LC2146 | MD |
NPI | 1003113614 |
---|---|
Provider Name | Mr. Norman Anthony Thompson |
First Address | Springdale, MD 20774-5449 |
Second Address | Springdale, MD 20774-5449 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2011 |
Last Update Date | 23/02/2011 |