Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | LP5421 | MN |
Y | 103T00000X | Psychologist | LP5421 | MN |
NPI | 1003181702 |
---|---|
Provider Name | Dr. Thomas Guy Farrington |
First Address | Saint Paul, MN 55116-1754 |
Second Address | Oakdale, MN 55128-3937 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2012 |
Last Update Date | 13/03/2012 |