Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YS0200X | School Counselor | 278518 | MN |
N | 1041C0700X | Clinical Social Worker | 06707 | MN |
NPI | 1083746085 |
---|---|
Provider Name | Ms. Kathy Maria Thomas |
First Address | Minneapolis, MN 55419-1626 |
Second Address | Minneapolis, MN 55419-1626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 08/07/2007 |