Provider Demographics
NPI:1730218215
Name:THOMPSON, PAMELA JEANNE (MS)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JEANNE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-6631
Mailing Address - Country:US
Mailing Address - Phone:931-993-6364
Mailing Address - Fax:
Practice Address - Street 1:203 INDEPENDENCE LN
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-3066
Practice Address - Country:US
Practice Address - Phone:423-562-4190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health