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Organization
THOMAS WALES, MSW, LICSW
Active
Organization
THOMAS WALES, MSW, LICSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS GWYNNE WALES MSW, LICSW (PSYCHOTHERAPIST)
(651) 699-1062
Entity
Organization
Contact information
Practice address
627 SNELLING AVE S, SUITE 200, SAINT PAUL, MN 55116-1590
(651) 699-1062
(651) 699-1084
Mailing address
627 SNELLING AVE S, SUITE 200, SAINT PAUL, MN 55116-1590
(651) 699-1062
(651) 699-1084
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14061
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090H8WA
BLUE CROSS BLUE SHIELD MN
MN
05
—
4442601-00
—
MN
Enumeration date
04/04/2007
Last updated
06/16/2008
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