Individual
LUKE THIBAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 EMMETT ST STE 102, KISSIMMEE, FL 34741-3605
(352) 232-4069
Mailing address
2105 CASSIA CIR APT A, KISSIMMEE, FL 34741-2872
(352) 232-4069
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI7353
FL
Other
Enumeration date
08/31/2024
Last updated
02/19/2025
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