Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 0000650 | CO |
N | 101YP1600X | Pastoral Counselor | 7099 | CO |
N | 225700000X | Massage Therapist | N/A | CO |
NPI | 1245407816 |
---|---|
Provider Name | Ms. Patricia Irene Thompson |
First Address | Sterling, CO 80751-3168 |
Second Address | Limon, CO 80828 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 30/12/2016 |