Individual
TERESA THREATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 323-0174
(706) 256-3264
Mailing address
13 PARADISE PT, FORT MITCHELL, AL 36856-4432
(706) 315-4046
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/03/2010
Last updated
12/03/2010
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