Individual
ELIZABETH K TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
950 E COUNTY LINE RD STE A, RIDGELAND, MS 39157-1928
(601) 308-5117
(601) 308-5103
Mailing address
804 PINE CIR, STARKVILLE, MS 39759-3732
(662) 769-0186
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3965
MS
Other
Enumeration date
07/28/2017
Last updated
07/28/2017
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