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Individual

ANNE T THACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LD

Contact information

Practice address
4614 PROSPECT AVE, STE 325, CLEVELAND, OH 44103-4377
(216) 777-2136
Mailing address
9930 JOHNNYCAKE RIDGE RD STE 6B, MENTOR, OH 44060-6766
(440) 357-6677
(440) 357-6681

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD 5190
OH

Other

Enumeration date
12/31/2009
Last updated
09/04/2020
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