Provider Demographics
NPI:1508020538
Name:THOMSON, BERNADETTE (BERNADETTE THOMSON)
Entity Type:Individual
Prefix:DR
First Name:BERNADETTE
Middle Name:
Last Name:THOMSON
Suffix:
Gender:F
Credentials:BERNADETTE THOMSON
Other - Prefix:
Other - First Name:BERNADETTE
Other - Middle Name:
Other - Last Name:BOSINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LP
Mailing Address - Street 1:6542 REGENCY LN
Mailing Address - Street 2:SUITE 213
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7847
Mailing Address - Country:US
Mailing Address - Phone:952-903-9214
Mailing Address - Fax:
Practice Address - Street 1:6542 REGENCY LN
Practice Address - Street 2:SUITE 213
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7847
Practice Address - Country:US
Practice Address - Phone:952-903-9214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2046103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist