Individual
MARY ALICE THIBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
603 BRUCE ST, CROOKSTON, MN 56716-2914
(218) 281-3940
(218) 281-6261
Mailing address
603 BRUCE ST, CROOKSTON, MN 56716-2914
(218) 281-3940
(218) 281-6261
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300182
MN
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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