Individual
ANNA GRACE DOROTHY THERIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
855 LAKEWOOD RD, WATERBURY, CT 06704-5408
(888) 793-3500
Mailing address
PO BOX 112, PLYMOUTH, CT 06782-0112
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/14/2025
Last updated
03/14/2025
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