Individual
KALEB M THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
203 ALLENDALE DR, PORT ALLEN, LA 70767-3219
(225) 389-1311
(225) 389-1330
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
239936
LA
Other
Enumeration date
03/06/2025
Last updated
03/06/2025
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