Individual
MARY SUSAN THUILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2155 N STATE ROAD 9, LAGRANGE, IN 46761-8746
(260) 463-7144
(260) 463-7146
Mailing address
PO BOX 817, KENDALLVILLE, IN 46755-0817
(260) 347-2453
(260) 347-2456
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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