Provider Demographics
NPI:1871654343
Name:SAWYER, THOMAS LEE JR (PSYD LP LICENSED PSY)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:LEE
Last Name:SAWYER
Suffix:JR
Gender:M
Credentials:PSYD LP LICENSED PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 CO RD 6
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:MN
Mailing Address - Zip Code:55356
Mailing Address - Country:US
Mailing Address - Phone:952-404-7466
Mailing Address - Fax:
Practice Address - Street 1:3405 CO RD 6
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:MN
Practice Address - Zip Code:55356
Practice Address - Country:US
Practice Address - Phone:952-404-7466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2745103T00000X, 103TC1900X
MN0765106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist