Individual
TERESA ANN NISBET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
612 WOODLAND SQUARE LOOP SE STE 401, LACEY, WA 98503-1070
(360) 890-6655
Mailing address
612 WOODLAND SQUARE LOOP SE STE 401, LACEY, WA 98503-1070
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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