| Doctor Name: | MARIANNE BERNADETTE THIRY |
| NPI Number: | 1063705929 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LADC |
| License Number: | 301772 |
| Business Practice Address: | 17305 Meadow Creek Lane Pine City, MN - 55063 |
| Business Phone Number: | 7634444878 |
| Business Fax Number: | |
| Mailing Address: | 37626 Rendova St Ne, STANCHFIELD |
| State: | MN |
| Postal Code: | 550805025 |
| Phone Number: | 3203963528 |
| Fax Number: | |
| NPI Enumeration Date: | 05/25/2011 |
| NPI Last Update Date: | 05/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 301772 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |