Provider Demographics
NPI:1447829817
Name:THOMPSON, CHRISTINA N
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:N
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 ADALINE DR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4412
Mailing Address - Country:US
Mailing Address - Phone:330-774-9536
Mailing Address - Fax:
Practice Address - Street 1:3414 ADALINE DR
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4412
Practice Address - Country:US
Practice Address - Phone:330-774-9536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator