| Doctor Name: | ANNA B THIBODO |
| NPI Number: | 1205122009 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSSLP-CCC |
| License Number: | 106090 |
| Business Practice Address: | 2400 Lakeview Dr Ste 102 Amarillo, TX - 791091532 |
| Business Phone Number: | 8064689400 |
| Business Fax Number: | 8064689401 |
| Mailing Address: | 2400 Lakeview Dr, Ste 102 AMARILLO |
| State: | TX |
| Postal Code: | 791091532 |
| Phone Number: | 8064689400 |
| Fax Number: | 8064689401 |
| NPI Enumeration Date: | 06/21/2011 |
| NPI Last Update Date: | 06/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 106090 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |