Individual
AMY E THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
91 MAPLE AVE, KEENE, NH 03431-1629
(603) 358-3384
(603) 358-6485
Mailing address
PO BOX 32, ANDOVER, NH 03216-0032
(800) 937-4245
(877) 521-6764
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1315
NH
Other
Enumeration date
05/16/2009
Last updated
10/04/2012
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