Provider Demographics
NPI:1245631449
Name:THOMPSON, SHELBY CATHERINE
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:CATHERINE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UWA
Mailing Address - Street 2:STATION 14
Mailing Address - City:LIVINGSTON
Mailing Address - State:AL
Mailing Address - Zip Code:35470
Mailing Address - Country:US
Mailing Address - Phone:205-652-3871
Mailing Address - Fax:
Practice Address - Street 1:UWA
Practice Address - Street 2:STATION 14
Practice Address - City:LIVINGSTON
Practice Address - State:AL
Practice Address - Zip Code:35470
Practice Address - Country:US
Practice Address - Phone:205-652-3871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer