Individual
JACQUELYN BETH THYM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
PO BOX 1510, HAWTHORNE, NV 89415-1510
(775) 945-2461
Mailing address
975 KIRMAN AVE, RENO, NV 89503
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1105497
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1105497
VA HEALTH ASSOICATION
—
Enumeration date
05/18/2017
Last updated
03/17/2018
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