| NPI | 1750026860 |
|---|---|
| Former Name | JULIE E THERIAULT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME CAC7863) |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2024-08-07 |