Provider Demographics
NPI:1588922033
Name:KATHERINE K THOMAS, INC
Entity type:Organization
Organization Name:KATHERINE K THOMAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:651-592-5197
Mailing Address - Street 1:539 BIELENBERG DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4436
Mailing Address - Country:US
Mailing Address - Phone:651-501-5159
Mailing Address - Fax:651-501-4148
Practice Address - Street 1:539 BIELENBERG DR
Practice Address - Street 2:SUITE 201
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4436
Practice Address - Country:US
Practice Address - Phone:651-501-5159
Practice Address - Fax:651-501-4148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4488251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health