Individual
KRISTIN THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 SUMMIT DR STE 402, PIKEVILLE, KY 41501-1580
(606) 430-2256
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 430-2256
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103K00000X
Behavior Analyst
Primary
299822
KY
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/01/2016
Last updated
06/17/2025
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