MS. Theresa M Moulton, LMT

NPI #1790199164 in Waukegan, Illinois

Provider Information

NPI Number: 1790199164
Entity Type: Individual
Name: MS. Theresa M Moulton, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: LMT
Enumeration Date: Jun 13, 2014
Last Updated: Jun 13, 2014

Practice Location

Address: 1400 SUNSET AVE
Address 2: SUITE 5
City: Waukegan
State: Illinois
ZIP Code: 60087-4806
Phone: (224) 730-9331

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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