Individual
MRS. CARLA BIBBY THATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
309 MILL ST, #101, OCCOQUAN, VA 22125
(703) 494-3949
(571) 295-3205
Mailing address
4907 CHASTE TREE PL, WOODBRIDGE, VA 22192-5440
(216) 269-6314
(571) 295-3205
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/16/2013
Last updated
01/16/2013
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