Individual
MRS. TANYA MAE THIBEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
SP1099
ME
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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