Individual
LISA THIBAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 CROSS ST, WILTON, ME 04294-4050
(207) 578-8351
Mailing address
14 CROSS ST, WILTON, ME 04294-4050
(207) 578-8351
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
048754
ME
163W00000X
Registered Nurse
553833
MA
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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