Individual
THERESA RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
235 S 3RD ST, SHELTON, WA 98584-2255
(360) 426-0890
Mailing address
235 SOUTH 3RD STREET, SHELTON, WA 98584
(360) 426-0890
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60346077
WA
Other
Enumeration date
09/01/2016
Last updated
03/24/2021
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