Individual
MRS. JENNIFER THERIAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
21 TRAILS END RD, WESTON, CT 06883-1236
(917) 532-1944
Mailing address
465 DANBURY RD., WILTON, CT 06897
(917) 532-1944
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004506
CT
Other
Enumeration date
12/30/2015
Last updated
12/30/2015
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