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1427391036
CLIFFORD THIBODEAU
PORTLAND, ME
NPI
1427391036
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ME LC3438)
Enumeration Date
2013-04-02
Last Update Date
2013-04-02
Business Address
-- CLIFFORD THIBODEAU LADC, CCS
65 INDIA ST
PORTLAND, ME 04101-4209
Phone number: 207-775-4790
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Mailing Address
-- CLIFFORD THIBODEAU LADC, CCS
65 INDIA ST
PORTLAND, ME 04101-4209
Phone number: 207-775-4790
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