Individual
MICHAEL THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MMHC
Contact information
Practice address
15 MEEKS RD, KINGSTON, NH 03848-3517
(603) 814-9360
Mailing address
15 MEEKS RD, KINGSTON, NH 03848-3517
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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