Individual
ADAM THIBEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5175 OLD CLEMMONS SCHOOL ROAD, WINSTON SALEM, NC 27102
(704) 780-4271
(888) 261-6694
Mailing address
6105 BUCKHORN RD, GREENSBORO, NC 27410-3223
(508) 688-0747
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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