Individual
ROBERT E THACKER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, IAADC,SAP
Contact information
Practice address
223 S. WALNUT AVE., AMES, IA 50010
(515) 233-1122
(515) 233-6500
Mailing address
223 S. WALNUT AVE., AMES, IA 50010
(515) 233-1122
(515) 233-6500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10159
IA
Other
Enumeration date
04/17/2007
Last updated
08/29/2013
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