Individual
CHERYL THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
312 HUDGINS ST, LOGAN, WV 25601-3534
(304) 896-5001
Mailing address
PO BOX 390, HUNTINGTON, WV 25708-0390
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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