Individual
ASHLEY THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
925 STATE ROUTE VV, KENNETT, MO 63857-3822
(573) 888-5925
Mailing address
925 STATE ROUTE VV, KENNETT, MO 63857-3822
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
15288
MO
Other
Enumeration date
06/13/2018
Last updated
02/27/2025
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