Individual
CAROLYN THERIAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
341 E JAMESTOWN RD UNIT 47, GREENVILLE, PA 16125-7309
(905) 766-1038
Mailing address
341 E JAMESTOWN RD UNIT 47, GREENVILLE, PA 16125-7309
(905) 766-1038
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3386
CA
225X00000X
Occupational Therapist
Primary
OC001517L
PA
Other
Enumeration date
12/19/2012
Last updated
12/19/2012
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