SAMUEL ELIJAH THIBODEAUX

ANAHEIM, CA
NPI1548008162
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA  008210973)
Enumeration Date2024-07-17
Last Update Date2024-07-24
Business Address
SAMUEL ELIJAH THIBODEAUX
601 S HARBOR BLVD
ANAHEIM, CA 92805-4521
Phone number: 714-908-0028
Mailing Address
SAMUEL ELIJAH THIBODEAUX
16662 IRBY LN
HUNTINGTON BEACH, CA 92647-4919
Phone number: 737-318-5140