Thibodeaux, Desiree
Thibodeaux, Desiree is an sole proprietor health care provider with primary practice located at 20 The Rays Trl Se , Bogue Chitto MS 39629-8500. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Thibodeaux, Desiree can be contacted via phone (601) 833-8363.Contact Information
Primary practice address
20 The Rays Trl Se
Bogue Chitto MS 39629-8500
Phone: (601) 833-8363
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | S2846 | Mississippi |
Profile Details
| NPI number | 1932329661 |
|---|---|
| LBN Legal business name | Thibodeaux, Desiree |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 26th, 2007 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932329661 | NPPES |
| Mississippi | MEDICAID | 07427004 |
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