Individual
JESSICA THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 1ST AVE S, GRAND FORKS, ND 58201-4565
(701) 757-2520
Mailing address
1405 1ST AVE N, GRAND FORKS, ND 58203-3484
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598367500
—
ND
Enumeration date
02/08/2022
Last updated
02/08/2022
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