Individual
FAITH ALICE THIBODEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
7 SIMPSON RD, SACO, ME 04072-9554
(207) 284-4537
(207) 284-4537
Mailing address
7 SIMPSON RD, SACO, ME 04072-9554
(207) 284-4537
(207) 284-4537
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D171
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001056
ANTHEM
ME
01
—
7773372
AETNA
ME
01
—
8760206
CIGNA
ME
01
—
P00300632
PALMETTO GBA
ME
Enumeration date
08/07/2006
Last updated
02/22/2010
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