Individual
MATTHEW JOHN THIBAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
86 TANDBERG TRAIL, WINDHAM, ME 04062-3411
(207) 893-0386
Mailing address
PO BOX 1360, WINDHAM, ME 04062-1360
(207) 893-0386
(207) 893-2086
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC12551
ME
Other
Enumeration date
05/31/2007
Last updated
01/04/2019
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