Individual
MS. JENNY THACKSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1712 STABLERSVILLE ROAD, WHITE HALL, MD 21161
(410) 913-9995
Mailing address
1712 STABLERSVILLE ROAD, WHITE HALL, MD 21161
(410) 913-9995
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
02339
MD
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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