Most Relevant Information
Provider Data
| NPI Number: | 1003570946 |
| Provider Name: | EDWARD THOMPSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/27/2021 |
| Last Updated: | 10/27/2021 |
Provider Practice Location
5834 ADENMOOR AVE
LAKEWOOD
CA
907131002
Practice Location Phone/Fax
| Phone: | 3039898169 |
| Fax: |
Provider Mailing Location
5834 ADENMOOR AVE
LAKEWOOD
CA
907131002
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |