Merril Thibodeaux
Counselor, Professional in Lafayette, LA. Individual provider (NPI-1).
NPI number1164081832
StatusActive
Last updated in NPPESJun 6, 2019
Details
- NPI
- 1164081832
- Entity type
- Individual (NPI-1)
- Name
- Merril Thibodeaux
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 6, 2019
- Last updated
- Jun 6, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 2 | LA | Yes |
Practice location
501 W Saint Mary Blvd Ste 210Lafayette, LA 70506-4699
Phone 337-233-1114
Mailing address
Po Box 53388Lafayette, LA 70505-3388
Phone 337-233-1114
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