Thibeault, Dylan Mackenzie

Thibeault, Dylan Mackenzie is an individual health care provider with primary practice located at 205 Burlington Rd , Bedford MA 01730-1406. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Behavioral Health & Social Service Providers / Behavior Technician is his primary health care specialty. Thibeault, Dylan Mackenzie can be contacted via phone (781) 761-5089.

Contact Information

Primary practice address
205 Burlington Rd Bedford MA 01730-1406
Phone: (781) 761-5089
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X

Profile Details

NPI number 1558825646
LBN Legal business name Thibeault, Dylan Mackenzie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2019
Last updated May 20th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558825646 NPPES
Massachusetts Other 1004745 FALLON
Massachusetts Other 1303287 FALLON
Massachusetts Other 99618201 FALLON
Massachusetts Other 0000023532 FALLON
Massachusetts Other 042611055 FALLON
Massachusetts Other 1004745 FALLON
Massachusetts Other M18633 FALLON

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