Individual
TANIL THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
15331 BEAR ISLAND RD, MAUREPAS, LA 70449-8233
(225) 571-8033
Mailing address
15331 BEAR ISLAND RD, MAUREPAS, LA 70449-8233
(225) 571-8033
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z11940
LA
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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