Individual
STEPHANIE THIBAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1372 NEWBURY NECK RD, SURRY, ME 04684-3819
(207) 356-8211
Mailing address
1372 NEWBURY NECK RD, SURRY, ME 04684-3819
(207) 356-8211
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2642
ME
Other
Enumeration date
09/05/2013
Last updated
09/05/2013
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