Individual
STACEY SACKETT THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13855 RIVER RD, LULING, LA 70070-6220
(985) 331-1018
Mailing address
13855 RIVER RD, LULING, LA 70070-6220
(985) 331-1018
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5110
LA
Other
Enumeration date
02/24/2022
Last updated
02/24/2022
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