Individual
KRISTEN LEIGH THACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
330 25TH ST, ASHLAND, KY 41101-7820
(066) 329-8588
Mailing address
2603 ADAMS AVE, HUNTINGTON, WV 25704-1334
(740) 357-9155
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.174239
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCIII.162430
OH
163W00000X
Registered Nurse
Primary
98443
KY
163WP0808X
Psychiatric/Mental Health Registered Nurse
98443
WV
Other
Enumeration date
01/15/2021
Last updated
06/12/2025
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