Most Relevant Information
Provider Data
| NPI Number: | 1003651035 |
| Provider Name: | ANNICK STEPHANIE THIBODEAU |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 113107 |
Most Important Dates
| Enumeration Date: | 07/01/2024 |
| Last Updated: | 07/01/2024 |
Provider Practice Location
1613 DUBIEL DR
LEANDER
TX
786414212
Practice Location Phone/Fax
| Phone: | 5122224072 |
| Fax: |
Provider Mailing Location
1613 DUBIEL DR
LEANDER
TX
786414212
Provider Mailing Phone/Fax
| Phone: | 5122224072 |
| Fax: |