Organization
MMT THERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE THIBODEAUX (LCSW)
(337) 501-8697
Entity
Organization
Contact information
Practice address
814 FORTUNE RD STE 108, YOUNGSVILLE, LA 70592-5542
(337) 513-0822
(337) 202-2376
Mailing address
8448 STEVE RD, KAPLAN, LA 70548-6437
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/11/2023
Last updated
09/27/2023
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