Individual
CALEB LEE THETFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC, MHP, CMHS, MA
Contact information
Practice address
61 GLENN RD N, MONTESANO, WA 98563-9767
(360) 500-6743
Mailing address
61 GLENN RD N, MONTESANO, WA 98563-9767
(360) 500-6743
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH60855835
WA
101YM0800X
Mental Health Counselor
MC 60637837
WA
Other
Enumeration date
05/11/2017
Last updated
09/25/2020
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