Individual provider · Type 1 NPI

Quinn Blake Thibodeau, LPC, NCC, M. COUN

Mental Health Counselor · Idaho Falls, ID

NPI number 1619102183 Active

Practice location

1891 Grandview Ct
Idaho Falls, ID 83402-2510

Call (208) 681-7182 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLPC-4361 (ID)
Social Worker 104100000XNone listed

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About NPI 1619102183

Quinn Blake Thibodeau, LPC, NCC, M. COUN's National Provider Identifier is 1619102183, issued on May 27, 2009. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Idaho Falls, ID. The record was last updated on Aug 12, 2009.