Individual
STEPHANIE LYN TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9250 PINECROFT DR, SHENANDOAH, TX 77380-3218
(713) 303-0252
Mailing address
21030 HARVEST TERRACE LN, SPRING, TX 77379-3081
(713) 303-0252
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2083321
TX
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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