Individual
JAKE D THIESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5006 LENKER ST, MECHANICSBURG, PA 17050-2440
(717) 730-0733
(717) 730-0696
Mailing address
105 YELLOW BREECHES DR, CAMP HILL, PA 17011-8351
(717) 730-0733
(717) 730-0696
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000107
PA
Other
Enumeration date
11/05/2005
Last updated
07/08/2007
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