Most Relevant Information
Provider Data
| NPI Number: | 1003246307 |
| Provider Name: | JEREMY THOMPSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 419456309 |
Most Important Dates
| Enumeration Date: | 11/22/2013 |
| Last Updated: | 11/22/2013 |
Provider Practice Location
54 S 3RD AVE
MOUNT VERNON
NY
105503303
Practice Location Phone/Fax
| Phone: | 9146644042 |
| Fax: |
Provider Mailing Location
902 FAIRWAY GRN
MAMARONECK
NY
105434325
Provider Mailing Phone/Fax
| Phone: | 9145236659 |
| Fax: |