Individual
MARY E THERRIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
792 STATE ST, BANGOR, ME 04401-5610
(207) 947-6508
(207) 941-8342
Mailing address
67 CLARK HILL RD, EAST HOLDEN, ME 04429-7248
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
CNP81724
ME
Other
Enumeration date
06/09/2006
Last updated
07/17/2013
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