Individual
MARY COLLINS THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(180) 084-9359
Mailing address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
31326
TX
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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