Provider Demographics
NPI:1104166958
Name:TREADWELL, CLAIRE MARIA (MS)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MARIA
Last Name:TREADWELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 MEMPHIS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-8385
Mailing Address - Country:US
Mailing Address - Phone:850-527-0949
Mailing Address - Fax:
Practice Address - Street 1:4606 MEMPHIS CHURCH RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-8385
Practice Address - Country:US
Practice Address - Phone:850-527-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health