Individual
HEIDI LYNN THACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 SCHOOL ST, FAIRFIELD, ME 04937-1370
(207) 453-4200
Mailing address
8 SCHOOL ST, FAIRFIELD, ME 04937-1370
(207) 453-4200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1011
ME
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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