Provider Demographics
NPI:1447436415
Name:THOMPSON, LEONA WILLIAMS (N/A)
Entity type:Individual
Prefix:MS
First Name:LEONA
Middle Name:WILLIAMS
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11708 CRITTON CIR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-1019
Mailing Address - Country:US
Mailing Address - Phone:703-201-4238
Mailing Address - Fax:
Practice Address - Street 1:11708 CRITTON CIR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-1019
Practice Address - Country:US
Practice Address - Phone:703-201-4238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator