Provider Information for 1205175585
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AMY IRENE THORSON MSW, LICSW, LADC
Sex: Female
NPI: 1205175585
Last Updated: 2022-04-08
Certification Date: 2022-04-08
Certification Date: 2022-04-08
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1205175585 | ||||||||||||
| Enumeration Date | 2013-02-07 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1240 ROBINHOOD LN SE OWATONNA, MN 55060-4600 United States Phone: 507-316-1341 | Fax: | ||||||||||||
| Primary Practice Address | 1240 ROBINHOOD LN SE OWATONNA, MN 55060-4600 United States Phone: 507-316-1341 | Fax: | ||||||||||||
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