| NPI | 1972852143 |
|---|---|
| Other Name | LAURA V THIESEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 17690) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AK 1187) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2023-09-07 |