Individual
LISA CHRISTINE THIBODEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
129741-121
Contact information
Practice address
1752 DORSET LN, NEW RICHMOND, WI 54017-2452
(715) 410-6772
Mailing address
1752 DORSET LN, NEW RICHMOND, WI 54017-2452
(715) 410-6772
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
129741-121
WI
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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