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1144824541
SHAWN LAMONT THACKER
PORT HURON, MI
NPI
1144824541
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2020-11-25
Last Update Date
2020-11-25
Business Address
SHAWN LAMONT THACKER
520 SUPERIOR ST
PORT HURON, MI 48060-3838
Phone number: 810-455-0102
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Mailing Address
SHAWN LAMONT THACKER
520 SUPERIOR ST
PORT HURON, MI 48060-3838
Phone number: 810-455-0102
Copy
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