Individual
MISS GILLIAN KATHLEEN TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7600 SLATE RIDGE BLVD, REYNOLDSBURG, OH 43068-8157
(614) 626-2696
Mailing address
7600 SLATE RIDGE BLVD, REYNOLDSBURG, OH 43068-8157
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.2406147
OH
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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