Jean Thiede
Behavior Technician in Jefferson, WI. Individual provider (NPI-1).
NPI number1144772575
StatusActive
Last updated in NPPESNov 2, 2016
Details
- NPI
- 1144772575
- Entity type
- Individual (NPI-1)
- Name
- Jean Thiede
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 2, 2016
- Last updated
- Nov 2, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1541 Annex RdJefferson, WI 53549-9803
Phone 920-674-8164
Mailing address
1541 Annex RdJefferson, WI 53549-9803
Phone 920-674-8164
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