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General NPI Number Information
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NPI Number | 1912088121
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Entity Type | Individual
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Provider Name | CAROLE ANN THIBODEAUX LAC AND RN
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 514 N COURT ST
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City | OPELOUSAS
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State | LA
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Zip | 70570-5220
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Country | US
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Telephone | 337-948-0228
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Fax | 337-948-0303
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Provider Business Mailing Address
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Address Line | 514 N. COURT ST.
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City | OPELOUSAS
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State | LA
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Zip | 70570
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Country | US
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Telephone | 337-948-0228
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Fax | 337-948-0303
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 868
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | RN046513
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License Number State | LA
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