Provider Demographics
NPI:1477875490
Name:THOMPSON, ROSAMOND (MA,LP)
Entity Type:Individual
Prefix:
First Name:ROSAMOND
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MA,LP
Other - Prefix:
Other - First Name:ROSAMOND
Other - Middle Name:
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 SILVER LAKE RD NW
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1786
Mailing Address - Country:US
Mailing Address - Phone:651-628-9566
Mailing Address - Fax:651-628-0411
Practice Address - Street 1:3801 W 50TH ST STE 250B
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-2070
Practice Address - Country:US
Practice Address - Phone:612-400-9685
Practice Address - Fax:612-437-4795
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5088103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist