| NPI | 1972804615 |
|---|---|
| Former Name | COURTNEY ANN THERIOT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 10799) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 10799) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2018-06-13 |