Individual
TRINA K THIBEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
226 STATE ROAD 19, MARSHALL, WI 53559-9796
(920) 227-8123
Mailing address
226 STATE ROAD 19, MARSHALL, WI 53559-9796
(920) 227-8123
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2025-027
WI
225X00000X
Occupational Therapist
Primary
5354-26
WI
Other
Enumeration date
01/31/2008
Last updated
11/19/2015
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