Individual
BRENT M THIBODAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
1271 BELLEVIEW ST, MORGAN CITY, LA 70380-5351
(985) 399-3330
(985) 399-3332
Mailing address
1271 BELLEVIEW ST, MORGAN CITY, LA 70380-5351
(985) 399-3330
(985) 399-3332
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1240
LA
Other
Enumeration date
04/06/2013
Last updated
04/06/2013
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