Individual
LIA KAY THIBODAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-3901
(336) 716-2261
(336) 716-9810
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2261
(336) 716-9810
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6003
NC
103T00000X
Psychologist
Primary
61029049
WA
Other
Enumeration date
01/15/2021
Last updated
11/03/2021
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