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1023792488
TIFFANY NICOLE THACKER
ASHLAND, KY
NPI
1023792488
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2023-06-14
Last Update Date
2023-06-16
Business Address
TIFFANY NICOLE THACKER
201 22ND ST
ASHLAND, KY 41101-7803
Phone number: 606-329-8588
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Mailing Address
TIFFANY NICOLE THACKER
PO BOX 790
ASHLAND, KY 41105-0790
Phone number: 606-329-8588
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