Provider Demographics
NPI:1306136445
Name:THERIEN, REBECCA ANN (MSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:THERIEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:A
Other - Last Name:COGGON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA
Mailing Address - Street 1:660 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-3550
Mailing Address - Country:US
Mailing Address - Phone:603-634-4446
Mailing Address - Fax:603-634-4446
Practice Address - Street 1:660 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-3550
Practice Address - Country:US
Practice Address - Phone:603-634-4446
Practice Address - Fax:603-634-4446
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker