Individual
STACY LEIGH THACKER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
10333 EL CAMINO REAL, ATASCADERO, CA 93423-7001
(805) 468-2000
(805) 466-6011
Mailing address
1600 9TH ST, ROOM 205 MAILSTOP 2-3, SACRAMENTO, CA 95814-6414
(916) 654-2431
(916) 654-3186
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
PSY16323
GA
Other
Enumeration date
05/17/2006
Last updated
07/08/2007
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