Individual
MS. MARY JUANITA THIBODEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7 WESTOWNE, LIBERTY, MO 66068
(816) 407-1754
Mailing address
1012 E 76TH ST, KANSAS CITY, MO 64131-2008
(816) 444-6533
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2002024986
MO
Other
Enumeration date
05/18/2007
Last updated
03/30/2010
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