| Omar Thompson Oral Thompson | |
|
20 Goodale Rd Apt 2 Boston MA 02126-1788 | |
| (617) 785-9459 | |
| Not Available |
| Full Name | Omar Thompson Oral Thompson |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 20 Goodale Rd Apt 2, Boston, Massachusetts |
| Authorized Official Name and Position | Omar Thompson (MENTOR) |
| Authorized Official Contact | 6177859459 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omar Thompson Oral Thompson 20 Goodale Rd Apt 2 Boston MA 02126-1788 Ph: (617) 785-9459 | Omar Thompson Oral Thompson 20 Goodale Rd Apt 2 Boston MA 02126-1788 Ph: (617) 785-9459 |
| NPI Number | 1396381539 |
|---|---|
| Provider Enumeration Date | 11/22/2019 |
| Last Update Date | 11/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396381539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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