Individual
MRS. LAURA MADELINE THIBAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2955 XENON ST, WHEAT RIDGE, CO 80215-6539
(254) 722-3651
Mailing address
2955 XENON ST, WHEAT RIDGE, CO 80215-6539
(254) 722-3651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09925593
CO
Other
Enumeration date
02/01/2020
Last updated
02/01/2020
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