Individual
DIANE MARIE THERRIAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
100 MILK STREET, METHUEN, MA 01844-1506
(978) 686-9900
(978) 688-7533
Mailing address
4 DUCKFORD CIR, NASHUA, NH 03063-1506
(603) 233-2157
(978) 688-7533
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
107468
MA
106S00000X
Behavior Technician
107468
MA
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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