Individual
RIAN THIBEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
2118 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2415
(612) 605-0623
Mailing address
2118 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2415
(612) 605-0623
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306403
MN
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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