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1346502218
MAIJA THACKERSON
LONG BEACH, CA
NPI
1346502218
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
167G00000X Licensed Psychiatric Technician
(Licence: CA PT 16398)
Enumeration Date
2012-06-15
Last Update Date
2012-06-15
Business Address
-- MAIJA THACKERSON L.P.T.
4151 E FOUNTAIN ST
LONG BEACH, CA 90804-3023
Phone number: 562-719-9250
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Mailing Address
-- MAIJA THACKERSON L.P.T.
4151 E FOUNTAIN ST
LONG BEACH, CA 90804-3023
Phone number:
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