MRS. Stacy Ann Thacker-Newsome, MA, LBD

NPI #1043686595 in Borden, Indiana

Provider Information

NPI Number: 1043686595
Entity Type: Individual
Name: MRS. Stacy Ann Thacker-Newsome, MA, LBD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: MA, LBD
Enumeration Date: Aug 19, 2015
Last Updated: Aug 19, 2015

Practice Location

Address: 15903 STATE ROAD 60
City: Borden
State: Indiana
ZIP Code: 47106-8629
Phone: (606) 831-1020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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