| NPI | 1942519152 |
|---|---|
| Former Name | JENNIFER THIBEAULT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM X-08726) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM M-06691) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0138441) | |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2015-02-10 |