Individual
MRS. VIRGINIA DARLENE TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFTA
Contact information
Practice address
1919 STATE ST, SUITE 322, NEW ALBANY, IN 47150-4929
(812) 944-2532
Mailing address
102 N HARRISON ST, SALEM, IN 47167-1426
(812) 528-0845
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
85000058A
IN
Other
Enumeration date
08/04/2010
Last updated
08/04/2010
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