Individual
AMY ELIZABETH THERIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 19TH STREET S, BIRMINGHAM, AL 35249-9990
(502) 656-8067
Mailing address
625 19TH ST S, BIRMINGHAM, AL 35233-1900
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
G12163
MD
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/23/2009
Last updated
03/30/2022
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