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Individual

MS. VIBHA THACKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MBA

Contact information

Practice address
105 S RIVERSIDE DR, 403, POMPANO BEACH, FL 33062-5500
(954) 317-0082
(954) 317-0083
Mailing address
105 S RIVERSIDE DR, 403, POMPANO BEACH, FL 33062-5500
(954) 317-0082
(954) 317-0083

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
231712
FL

Other

Enumeration date
06/16/2010
Last updated
06/16/2010
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