| Doctor Name: | MRS. HOLLY THIELE |
| NPI Number: | 1144640764 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 1088 |
| Business Practice Address: | 645 Osage St Sidney, NE - 691621714 |
| Business Phone Number: | 3082545825 |
| Business Fax Number: | |
| Mailing Address: | 645 Osage St, SIDNEY |
| State: | NE |
| Postal Code: | 691621714 |
| Phone Number: | 3082545825 |
| Fax Number: | |
| NPI Enumeration Date: | 04/22/2014 |
| NPI Last Update Date: | 04/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | 1088 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |