Individual
ANN CHRISTINE THERIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
425 E MAIN ST, OTHELLO, WA 99344-1146
(509) 488-5611
Mailing address
425 E MAIN ST, OTHELLO, WA 99344-1146
(509) 488-5611
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CG60374065
WA
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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