Individual
DR. TRACEY THIBODEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LAC, EDD
Contact information
Practice address
9302 W 121ST TER, OVERLAND PARK, KS 66213-1547
(951) 255-8242
Mailing address
9302 W 121ST TER, OVERLAND PARK, KS 66213-1547
(951) 255-8242
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
01942
KS
101YP2500X
Professional Counselor
Primary
04842
KS
Other
Enumeration date
10/11/2024
Last updated
10/11/2024
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