| Doctor Name: | MARY BETH THOMAS |
| NPI Number: | 1184746133 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICSW |
| License Number: | 993074 |
| Business Practice Address: | 207 Avenue C Suite 202 Cloquet, MN - 557201584 |
| Business Phone Number: | 2186553347 |
| Business Fax Number: | 2186553390 |
| Mailing Address: | 207 Avenue C, Suite 202 CLOQUET |
| State: | MN |
| Postal Code: | 557201584 |
| Phone Number: | 2186553347 |
| Fax Number: | |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 01/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 993074 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |