Individual
TIFFANY A THERIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
16801 NEWBURGH RD STE 114, LIVONIA, MI 48154-1606
(248) 910-3644
(248) 773-7035
Mailing address
5000 TOWN CTR STE 2001, SOUTHFIELD, MI 48075-1116
(248) 352-0314
(248) 281-0759
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/15/2010
Last updated
02/15/2010
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