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Individual

LISA THIBODEAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
201 HAMNER DR, HOUMA, LA 70364-1019
(985) 860-2038
Mailing address
201 HAMNER DR, HOUMA, LA 70364-1019
(985) 860-2038

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
8064
LA
1041C0700X
Clinical Social Worker
8064
LA
1041S0200X
School Social Worker
Primary
8064
LA

Other

Enumeration date
03/08/2012
Last updated
03/08/2012
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