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Individual

MS. DOROTHY THIBAULT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2 CARDINAL PARK DR SE, SUITE 104A, LEESBURG, VA 20175-4448
(703) 391-8513
Mailing address
2 CARDINAL PARK DR SE, SUITE 104A, LEESBURG, VA 20175-4448
(703) 391-8513

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001840
VA

Other

Enumeration date
10/02/2006
Last updated
07/21/2010
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