Individual
ERIN THERIAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 WINSHIP ST, BRIGHTON, MA 02135-3359
(413) 896-8972
Mailing address
9 WINSHIP ST, BRIGHTON, MA 02135-3359
(413) 896-8972
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
S94640572
MA
101YM0800X
Mental Health Counselor
S94640572
MA
Other
Enumeration date
12/06/2013
Last updated
12/06/2013
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