Individual
DR. JOHN R THIBODEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
296 NEW WATERFORD PL, LONGWOOD, FL 32779-5656
(321) 972-5693
(321) 972-5693
Mailing address
296 NEW WATERFORD PL, LONGWOOD, FL 32779-5656
(321) 972-5693
(321) 972-5693
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 7684
FL
Other
Enumeration date
09/08/2006
Last updated
07/01/2009
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