Individual
CRISINDA TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC-SUPV
Contact information
Practice address
4913 BONNIE RD, DAYTON, OH 45440-2126
(937) 546-7858
Mailing address
4913 BONNIE RD, DAYTON, OH 45440-2126
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E.0008294-SUPV
OH
Other
Enumeration date
12/29/2025
Last updated
12/30/2025
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