Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ||
N | 104100000X | Social Worker | 102335 | NY |
Y | 1041C0700X | Clinical Social Worker | 092380 | NY |
NPI | 1003365792 |
---|---|
Provider Name | Stephanie Ann Thompson |
First Address | Oneida, NY 13421-2106 |
Second Address | Wampsville, NY 13163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2016 |
Last Update Date | 11/01/2022 |