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Individual
KRISTI LYNNE TACKETT-NEWBURG
Active
Individual
KRISTI LYNNE TACKETT-NEWBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LIMHP CPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
293
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025043400
—
NE
Enumeration date
05/14/2007
Last updated
12/01/2020
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