IndividualActive
Rose Thacker
NPI 1073093290 · Developmental - Behavioral Pediatrics Physician · Bingham Farms, MI
Provider details
- NPI number
- 1073093290
- Entity type
- Individual
- Primary specialty
- Developmental - Behavioral Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- 2080P0006X (MI)
Practice location
32100 Telegraph Rd Ste 185
Bingham Farms, MI 48025-2453
Phone: (248) 217-4266
Fax: (248) 712-4381
Mailing address
32100 Telegraph Rd Ste 205
Bingham Farms, MI 48025-2454
Registry dates
- Enumerated
- 2018-08-16
- Last updated
- 2018-08-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.