Individual
ANYA THETFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
15656 SW BRISTLECONE WAY, TIGARD, OR 97223-2689
(724) 494-4564
Mailing address
15656 SW BRISTLECONE WAY, TIGARD, OR 97223-2689
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L10720
OR
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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