Individual
MR. JASON GREGORY THYMIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
540 E 1ST ST, WACONIA, MN 55387-1600
(952) 442-4437
(952) 442-3084
Mailing address
540 E 1ST ST, WACONIA, MN 55387-1600
(952) 442-4437
(952) 442-3084
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20344
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A097725000
—
MN
Enumeration date
10/26/2012
Last updated
01/09/2019
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