Individual
DR. BONNY ELIZABETH THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
704 E HIGHWAY 28, OWENSVILLE, MO 65066-1588
(573) 437-2959
Mailing address
180 COMMUNITY, CLINTON, MO 64735-8804
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2013006401
MO
Other
Enumeration date
01/01/2013
Last updated
02/07/2025
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