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1821527011
ERIC THACKER
MONROE, LA
NPI
1821527011
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: LA 7145)
Enumeration Date
2017-06-09
Last Update Date
2020-06-10
Business Address
Mr. ERIC THACKER
622 RIVERSIDE DR
MONROE, LA 71201-6211
Phone number: 318-398-0945
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Mailing Address
Mr. ERIC THACKER
107 ASHFORD DR APT 511
WEST MONROE, LA 71291-7851
Phone number: 318-557-5953
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