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Individual
KORY THATCH
Active
Individual
KORY THATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHPP
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/20/2017
Last updated
06/05/2018
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