Provider Demographics
NPI:1447879341
Name:THOMPSON, DYONNE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DYONNE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 CHRISTINA DR APT 301
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33414-2192
Mailing Address - Country:US
Mailing Address - Phone:727-215-5078
Mailing Address - Fax:
Practice Address - Street 1:401 N ROSEMARY AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-4133
Practice Address - Country:US
Practice Address - Phone:561-714-6968
Practice Address - Fax:561-209-2771
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA16773235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist