Doctor Name: | SARAH B THIBAULT |
NPI Number: | 1174706246 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW-C |
License Number: | 12268 |
Business Practice Address: | 12145 Elm St Princess Anne, MD - 218531358 |
Business Phone Number: | 4106519852 |
Business Fax Number: | 4106511279 |
Mailing Address: | Po Box 191, PRINCESS ANNE |
State: | MD |
Postal Code: | 218530191 |
Phone Number: | 4106519852 |
Fax Number: | 4106511279 |
NPI Enumeration Date: | 12/12/2007 |
NPI Last Update Date: | 04/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 12268 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |