Individual
RICHARD LOUIS THIBAULT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 CIRCLE AVE, LYNN, MA 01905-3050
(781) 595-2413
(781) 596-0113
Mailing address
15 WINTER ST APT 9, SALEM, MA 01970-3865
(978) 786-2788
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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