Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | AAPC FELLOW #4044 | |
Y | 103TC1900X | Counseling Psychologist | 3857 | MN |
N | 103TP2701X | Group Psychotherapist | 3857 | MN |
NPI | 1093849465 |
---|---|
Provider Name | Ms. Susan Louise Thornton |
First Address | Minneapolis, MN 55403-2419 |
Second Address | Minneapolis, MN 55403-2419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 26/02/2015 |