Individual
JACOB THICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, PMHNP
Contact information
Practice address
200 SPRINGS RD, BEDFORD, MA 01730-1114
(781) 687-3897
Mailing address
6 BRIDGE STREET, APARTMENT 203, NASHUA, NH 03060
(207) 286-4899
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN80265
ME
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN10013015
MA
Other
Enumeration date
07/05/2024
Last updated
08/13/2024
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