Basic Information
| Provider Information | |||||||||
| NPI: | 1376090803 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMPSON | ||||||||
| FirstName: | EMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 687 HIGHLAND AVENUE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | NEEDHAM HEIGHTS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004558726 | ||||||||
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| Practice Location | |||||||||
| Address1: | 687 HIGHLAND AVENUE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | NEEDHAM HEIGHTS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004558726 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2016 | ||||||||
| LastUpdateDate: | 09/01/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 222015 | MA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.