Individual
RAIME THIBODEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LPC
Contact information
Practice address
403A HICKORY ST, THIBODAUX, LA 70301-2013
(225) 802-3075
Mailing address
330 TETREAU ST, THIBODAUX, LA 70301-3538
(225) 802-3075
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3863
LA
101YP2500X
Professional Counselor
Primary
3863
LA
Other
Enumeration date
04/01/2011
Last updated
10/20/2011
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