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Organization
LYNN M. THEBO, LCSW, PLLC
Active
Organization
LYNN M. THEBO, LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNN MARIE THEBO LCSW (OWNER/LCSW)
(325) 939-7641
Entity
Organization
Contact information
Practice address
3109 SOUTHWEST BLVD. STE. B, SAN ANGELO, TX 76904
(325) 939-7641
Mailing address
3109 SOUTHWEST BLVD., STE. B, SAN ANGELO, TX 76904
(325) 939-7641
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
50867
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
348226
MEDICARE PTAN
TX
Enumeration date
02/03/2014
Last updated
02/23/2016
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