Provider Demographics
NPI:1013484120
Name:LENNA THIEMAN
Entity Type:Organization
Organization Name:LENNA THIEMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DESIRAE
Authorized Official - Middle Name:
Authorized Official - Last Name:VOBR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:605-842-1209
Mailing Address - Street 1:417 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINNER
Mailing Address - State:SD
Mailing Address - Zip Code:57580-1794
Mailing Address - Country:US
Mailing Address - Phone:605-842-1209
Mailing Address - Fax:605-842-2284
Practice Address - Street 1:417 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WINNER
Practice Address - State:SD
Practice Address - Zip Code:57580-1794
Practice Address - Country:US
Practice Address - Phone:605-842-1209
Practice Address - Fax:605-842-2284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech