Individual
JOSHUA WAYNE TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADCA
Contact information
Practice address
233 PARKERS MILL WAY # USA, SOMERSET, KY 42503-4152
(606) 485-9323
Mailing address
375 CANTERBURY DR, SCIENCE HILL, KY 42553-7242
(606) 729-6919
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
282467
KY
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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