Provider Demographics
NPI:1366328130
Name:THOMPSON, MADISON ANNE (MA CF-SLP)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:ANNE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MA CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5424 WHITEFORD RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2522
Mailing Address - Country:US
Mailing Address - Phone:419-824-8612
Mailing Address - Fax:419-824-8639
Practice Address - Street 1:5424 WHITEFORD RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2522
Practice Address - Country:US
Practice Address - Phone:419-824-8612
Practice Address - Fax:419-824-8639
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20253111-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist