Individual
THEODORE MCTIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4010 DUPONT CIR STE 226, LOUISVILLE, KY 40207-4847
(502) 896-8006
Mailing address
4010 DUPONT CIR STE 226, LOUISVILLE, KY 40207-4847
(502) 896-8006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
246100
KY
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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