Individual
AMANDA TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9501
(304) 429-6741
Mailing address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9501
(304) 429-6741
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
255594
KY
172V00000X
Community Health Worker
—
—
Other
Enumeration date
03/01/2019
Last updated
03/29/2023
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