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1174265664
CORY L THACKER
NAMPA, ID
NPI
1174265664
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID 9457)
Enumeration Date
2022-04-13
Last Update Date
2023-04-10
Business Address
CORY L THACKER LPC
220 10TH AVE S
NAMPA, ID 83651-3832
Phone number: 208-468-0850
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Mailing Address
CORY L THACKER LPC
220 10TH AVE S
NAMPA, ID 83651-3832
Phone number:
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