Provider Demographics
NPI:1861017063
Name:THOMAN, JORDYN ASHLEY
Entity type:Individual
Prefix:
First Name:JORDYN
Middle Name:ASHLEY
Last Name:THOMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 CASCADING FALLS LN
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37876-0656
Mailing Address - Country:US
Mailing Address - Phone:386-871-8127
Mailing Address - Fax:
Practice Address - Street 1:417 E LAMAR ALEXANDER PKWY
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-5816
Practice Address - Country:US
Practice Address - Phone:865-277-9402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2010103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst