Provider Demographics
NPI:1598024028
Name:THIBODEAU, MARGARET (ND)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:THIBODEAU
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 ASHVILLE AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6130
Mailing Address - Country:US
Mailing Address - Phone:919-858-1004
Mailing Address - Fax:
Practice Address - Street 1:222 ASHVILLE AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6130
Practice Address - Country:US
Practice Address - Phone:919-858-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0000258175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath