Individual
NICOLE THIBAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
225 HOPMEADOW ST STE 500, WEATOGUE, CT 06089-7901
(860) 470-3391
Mailing address
225 HOPMEADOW ST STE 500, WEATOGUE, CT 06089-7901
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6256
CT
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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