Individual
MS. KRISTEN SARAH THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LLP, LPCC
Contact information
Practice address
38875 LYNDON ST, LIVONIA, MI 48154
(734) 673-9190
Mailing address
1481 S TRAIL CIR, FARIBAULT, MN 55021-7071
(734) 673-9190
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
CC00084
MN
103TC0700X
Clinical Psychologist
Primary
6301012278
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912053174
MEDICAL ASSISTANCE (MA)
MN
Enumeration date
01/28/2007
Last updated
07/12/2018
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