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1760844351
TIMMY THACKER
MARION, OH
NPI
1760844351
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH 150614)
Enumeration Date
2016-03-23
Last Update Date
2016-03-23
Business Address
-- TIMMY THACKER CDCA
320 EXECUTIVE DR
MARION, OH 43302-6310
Phone number: 740-387-5210
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Mailing Address
-- TIMMY THACKER CDCA
320 EXECUTIVE DR
MARION, OH 43302-6310
Phone number: 740-387-5210
Copy
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