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General NPI Number Information
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NPI Number | 1861017063
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Entity Type | Individual
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Provider Name | JORDYN ASHLEY THOMAN
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Gender | Female
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Dates
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Enumeration Date | 06/12/2020
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 417 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5816
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Country | US
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Telephone | 865-277-9402
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Fax |
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Provider Business Mailing Address
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Address Line | 1619 CASCADING FALLS LN
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City | SEVIERVILLE
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State | TN
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Zip | 37876-0656
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Country | US
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Telephone | 386-871-8127
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 2010
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License Number State | TN
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