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Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Work Site Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (CONTRACT MANAGER)
(985) 493-4907
Entity
Organization
Contact information
Practice address
400 N ACADIA RD, THIBODAUX, LA 70301-4856
(985) 493-4004
Mailing address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 493-4740
(985) 449-2585
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
—
NULL
136A00000X
Registered Dietetic Technician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/29/2021
Last updated
05/09/2024
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