Provider Demographics
NPI:1629313697
Name:THOMPSON, ALISON (OTR)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8610 S MARYLAND PKWY
Mailing Address - Street 2:APT.3115
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2709
Mailing Address - Country:US
Mailing Address - Phone:414-416-9343
Mailing Address - Fax:
Practice Address - Street 1:750 CORONADO CENTER DR
Practice Address - Street 2:140
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5034
Practice Address - Country:US
Practice Address - Phone:702-312-4878
Practice Address - Fax:702-312-4886
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5258-26225X00000X
NV14-0473225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist