Individual
TERESA M TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
1111 US HIGHWAY 60 W, MOREHEAD, KY 40351-6130
(606) 402-3001
Mailing address
1111 US HIGHWAY 60 W, MOREHEAD, KY 40351-6130
(606) 402-3001
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
260257
KY
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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