SHANE EDWARD THERIAULT

CARIBOU, ME
NPI1649397928
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
(Licence: ME  LSX8780)
Enumeration Date2007-03-23
Last Update Date2007-07-08
Business Address
Mr. SHANE EDWARD THERIAULT LSW-C
4 LOMBARD RD.
CARIBOU, ME 04736-0748
Phone number: 207-498-2575
Mailing Address
Mr. SHANE EDWARD THERIAULT LSW-C
24 COOLIDGE AVE
CARIBOU, ME 04736-2406
Phone number: 207-493-1067
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