Individual
AUTUMN ANN THIBAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
205 W BAYSHORE BLVD, JACKSONVILLE, NC 28540-5339
(910) 347-9111
(910) 347-9711
Mailing address
205 W BAYSHORE BLVD, JACKSONVILLE, NC 28540-5339
(910) 347-9111
(910) 347-9711
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
01756
NC
Other
Enumeration date
10/21/2022
Last updated
10/28/2025
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