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Individual

DR. THOMSON F DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
3537 LAKE ELMO AVE N, SUITE 190, LAKE ELMO, MN 55042-7405
(651) 773-2010
Mailing address
3537 LAKE ELMO AVE N, P.O. BOX 277, LAKE ELMO, MN 55042-7405
(651) 773-2010

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
LP1034
MN

Other

Enumeration date
04/18/2007
Last updated
07/08/2007
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