Individual
MRS. MARY LYNN THIENEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMFT
Contact information
Practice address
8521 LAGRANGE RD, PHYSICIAN'S BLDG, LOUISVILLE, KY 40242-3800
(502) 644-5433
(502) 814-3745
Mailing address
PO BOX 22816, LOUISVILLE, KY 40252-0816
(502) 644-5433
(502) 814-3745
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0885
KY
106H00000X
Marriage & Family Therapist
Primary
0440
KY
Other
Enumeration date
10/02/2006
Last updated
05/04/2016
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