Search › Maine › 104100000X
Shane Theriault, LSW-C
NPI 1649397928 · on the registry since 2007
Practice
- Address
- 4 Lombard Rd.
Caribou, ME 04736 - Phone
- (207) 498-2575
- Fax
- (207) 492-2410
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- ME
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maine