Individual
ANGELA DAWN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC, LADC
Contact information
Practice address
516 S POKEGAMA AVE, GRAND RAPIDS, MN 55744-3820
(218) 327-2001
Mailing address
505 SE 21ST ST APT 305, GRAND RAPIDS, MN 55744-2368
(218) 910-8147
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305922
MN
101YM0800X
Mental Health Counselor
CC04277
MN
101YP2500X
Professional Counselor
Primary
CC04277
MN
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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