1902123987

Everything you always wanted to know about THOMPSON E KEVIN LPC but were afraid to ask.

THOMPSON E KEVIN LPC

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Provider Last Name Provider Middle Name Provider First Name Provider Credential
THOMPSON E KEVIN LPC
Gender:
Male
Enumeration date:
2010-04-29
Last update date:
2014-09-18
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state
1437137734 Medicaid none VA

Taxonomies

Taxonomy State License Number Primary?
101YP1600X Pastoral VA 0701004805

Phone Numbers

Type Number
Mailing Address Telephone Number 5407748258
Practice Location Address Telephone Number 5407748258

Addresses

Type Address City State Postal Country
Mailing Address 8261 OLD TAVERN RD ROANOKE VA 24019 VA
Practice Location Address 8261 OLD TAVERN RD ROANOKE VA 24019 VA

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