Individual
CARLY THATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2995 SUB ZERO PKWY, FITCHBURG, WI 53719-8801
(608) 819-6394
Mailing address
9315 FORTUNATE PL APT 212, VERONA, WI 53593-9388
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7264-27
WI
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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