Individual
JILLIAN STACEY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2053 YORKSHIRE AVE APT 101, SAINT PAUL, MN 55116-2569
(970) 568-2844
Mailing address
PO BOX 6511, MINNEAPOLIS, MN 55406-0511
(970) 568-2844
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
—
—
225X00000X
Occupational Therapist
Primary
104662
MN
Other
Enumeration date
12/14/2006
Last updated
12/05/2016
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