JEREMY STEPHEN THACKER

STUDIO CITY, CA
NPI1508661794
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: CA  PSB94027985)
Enumeration Date2025-02-13
Last Update Date2025-02-13
Business Address
JEREMY STEPHEN THACKER
11712 MOORPARK ST STE 204B
STUDIO CITY, CA 91604-2158
Phone number: 323-834-2420
Mailing Address
JEREMY STEPHEN THACKER
11712 MOORPARK ST STE 204B
STUDIO CITY, CA 91604-2158
Phone number: 323-834-2420
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