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Individual

SHELBY THACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
131 SUMMIT DR STE 402, PIKEVILLE, KY 41501-1580
(606) 430-2256
(606) 218-6577
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 430-2256
(606) 218-6577

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
303362
KY
106S00000X
Behavior Technician

Other

Enumeration date
07/19/2023
Last updated
11/04/2025
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