Individual
GIANNA WUERL THACKER
Active
Individual
GIANNA WUERL THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0000005908
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60054
AETNA
GA
05
—
928870415A
—
GA
01
—
9344540
PHCS
GA
Enumeration date
02/20/2007
Last updated
03/23/2020
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