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1063485761
EDWARD JOSEPH THIBODEAU
CANANDAIGUA, NY
NPI
1063485761
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NJ 44SC04888700)
Enumeration Date
2006-02-12
Last Update Date
2010-10-02
Business Address
Mr. EDWARD JOSEPH THIBODEAU MSSA
5234 OVERLOOK LN
CANANDAIGUA, NY 14424-9111
Phone number: 585-331-9320
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Mailing Address
Mr. EDWARD JOSEPH THIBODEAU MSSA
5234 OVERLOOK LN
CANANDAIGUA, NY 14424-9111
Phone number: 585-331-9320
Copy
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