Provider Demographics
NPI:1508749086
Name:THOMPSON, MANDY KAY (SCHOOL PSYCHOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:KAY
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:MISS
Other - First Name:MANDY
Other - Middle Name:KAY
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10532 N 117TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-6697
Mailing Address - Country:US
Mailing Address - Phone:918-500-3488
Mailing Address - Fax:
Practice Address - Street 1:10532 N 117TH EAST AVE
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-6697
Practice Address - Country:US
Practice Address - Phone:918-500-3488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK412796103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool