| Linda Thibault, Psy. D., Lp, Pllc | |
|
20793 Farmington Rd Suite #17 Farmington Hills MI 48336-5182 | |
| (734) 657-8443 | |
| Not Available |
| Full Name | Linda Thibault, Psy. D., Lp, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 20793 Farmington Rd, Farmington Hills, Michigan |
| Authorized Official Name and Position | Linda Thibault (OWNER/PROPRIETOR) |
| Authorized Official Contact | 7346578443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Linda Thibault, Psy. D., Lp, Pllc 20793 Farmington Rd Suite #17 Farmington Hills MI 48336-5182 Ph: (734) 657-8443 | Linda Thibault, Psy. D., Lp, Pllc 20793 Farmington Rd Suite #17 Farmington Hills MI 48336-5182 Ph: (734) 657-8443 |
| NPI Number | 1487911020 |
|---|---|
| Provider Enumeration Date | 04/20/2012 |
| Last Update Date | 12/11/2013 |
| Medicare PECOS PAC ID | 4789812520 |
|---|---|
| Medicare Enrollment ID | O20140124000633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487911020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 6301014245 (Michigan) | Primary |
| Provider Name | Linda A Thibault |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952311201 PECOS PAC ID: 2163683459 Enrollment ID: I20120412000764 |
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