Individual
MELINDA KAY THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 MEDICAL DR STE D101, BOUNTIFUL, UT 84010-8905
(385) 275-0492
Mailing address
415 MEDICAL DR STE D101, BOUNTIFUL, UT 84010-8905
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12886430-4104
UT
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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