Individual
DEIRDRE THIBAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 MEADOWBROOK RD, BROCKTON, MA 02301-7122
(508) 742-4424
Mailing address
10 MEADOWBROOK RD, BROCKTON, MA 02301-7122
(508) 742-4424
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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