Provider Demographics
NPI:1548892250
Name:THOMPSON, AMANDA (MS, CGC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:BARTENBAKER THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:5311 WESTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4166
Mailing Address - Country:US
Mailing Address - Phone:248-330-4832
Mailing Address - Fax:
Practice Address - Street 1:207 PERRY PKWY
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2142
Practice Address - Country:US
Practice Address - Phone:888-729-1206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS