Individual
CARRIE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
613 RUSSELL PKWY STE B, WARNER ROBINS, GA 31088-7644
(478) 273-3381
Mailing address
516 WHISTLER LN N, MACON, GA 31210-7601
(478) 390-4115
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005660
GA
Other
Enumeration date
06/30/2026
Last updated
06/30/2026
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