Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 274 | SD |
N | 103T00000X | Psychologist | 274 | SD |
N | 103TC1900X | Counseling Psychologist | 274 | SD |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 274 | SD |
N | 103TS0200X | School Psychologist | 274 | SD |
NPI | 1003957994 |
---|---|
Provider Name | Dr. Thomas Charles Himler |
First Address | Davis, SD 57021-6518 |
Second Address | Sioux Falls, SD 57105-1025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 08/07/2007 |