Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 3025 | MN |
N | 102L00000X | Psychologist | 3025 | MN |
N | 103T00000X | Psychologist | 3025 | MN |
N | 103TC1900X | Counseling Psychologist | 3025 | MN |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 3025 | MN |
N | 103TF0000X | Family Psychologist | 3025 | MN |
NPI | 1053399972 |
---|---|
Provider Name | Ms. Sheila Louise Thomas |
First Address | Saint Paul, MN 55108-1737 |
Second Address | Saint Paul, MN 55108-1737 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043470 | PREFERRED ONE (01) | MN |
407L1TH | BLUE CROSS BLUE SHIELD (01) | MN |
6255739 | MEDICA/UBH (01) | MN |