Individual
CHRISTA THEG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 HALCYON FARM RD, LAKEVILLE, MA 02347-2243
(774) 766-9634
Mailing address
5 HALCYON FARM RD, LAKEVILLE, MA 02347-2243
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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