Individual
MS. JANE LYNN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LICSW
Contact information
Practice address
11000 PRAIRIE LAKES DR, SUITE 610, EDEN PRAIRIE, MN 55344-3887
(612) 991-4019
Mailing address
11000 PRAIRIE LAKES DR, SUITE 610, EDEN PRAIRIE, MN 55344-3887
(612) 991-4019
(952) 942-5141
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LICSW00630
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209MIED
BLUE CROSS BLUE SHIELD
MN
01
—
6269233
MEDICA
—
Enumeration date
10/23/2006
Last updated
07/08/2007
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