Individual
SHEILA THIBODEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CCS
Contact information
Practice address
193 EXCHANGE ST, BANGOR, ME 04401-6507
(207) 299-3265
(207) 941-9333
Mailing address
18 REINZO LN, BANGOR, ME 04401-2665
(207) 299-3265
(207) 941-9333
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6135
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202720099
—
ME
Enumeration date
09/26/2006
Last updated
07/15/2010
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