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Individual

CHRISTIAN THIBEAULT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1695 MAIN ST FL 400, SPRINGFIELD, MA 01103-1063
(413) 739-5572
Mailing address
23 BOG HOLLOW RD, SPRINGFIELD, MA 01109-1420
(518) 337-8182

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
06/21/2015
Last updated
06/21/2015
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