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General NPI Number Information
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NPI Number | 1821115494
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Entity Type | Individual
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Provider Name | CAROL ANN THERRIEN M.S., LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 1750 ELLINGTON RD #3
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-2746
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Country | US
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Telephone | 860-478-7702
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Fax | 860-432-1335
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Provider Business Mailing Address
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Address Line | 307 CEDAR SWAMP RD
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City | COVENTRY
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State | CT
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Zip | 06238-1068
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Country | US
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Telephone | 860-478-7702
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Fax | 860-432-1335
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 000619
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License Number State | CT
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