National Provider Identifier
Edward Joseph Thibodeau, MSSA
Edward Joseph Thibodeau, MSSA is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Canandaigua, NY and a listed phone number of (585) 331-9320.
Profile Overview
- NPI
- 1063485761
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- February 12, 2006
- Last Updated
- October 02, 2010
Practice Location
- 5234 Overlook Ln
- Canandaigua, NY 14424-9111
Phone: (585) 331-9320
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1063485761
- Entity Type
- Individual
- Last Name
- Thibodeau
- First Name
- Edward
- Middle Name
- Joseph
- Name Prefix
- Mr.
- Credential
- MSSA
- Mailing Street Address
- 5234 Overlook Ln
- Mailing City
- Canandaigua
- Mailing State
- NY
- Mailing ZIP Code
- 14424-9111
- Mailing Country
- US
- Mailing Phone
- (585) 331-9320
- Practice Street Address
- 5234 Overlook Ln
- Practice City
- Canandaigua
- Practice State
- NY
- Practice ZIP Code
- 14424-9111
- Practice Country
- US
- Practice Phone
- (585) 331-9320
- Enumeration Date
- February 12, 2006
- Last Updated
- October 02, 2010
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)