Individual
COREY RICHARD THERRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
161 W RODEO RD, CASA GRANDE, AZ 85122-6498
(520) 421-4964
(520) 421-4966
Mailing address
161 W RODEO RD, CASA GRANDE, AZ 85122-6498
(520) 421-4964
(520) 421-4966
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-007108
AZ
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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