Individual
JULIE ANN THACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
1196 E ALTADONNA ST, QUEEN CREEK, AZ 85240-7846
(480) 274-3951
Mailing address
1822 S 39TH ST UNIT 25, MESA, AZ 85206-3828
(480) 926-2868
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3944
AZ
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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