Individual
KIERRA TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
374 N KY 7, SANDY HOOK, KY 41171-7938
(606) 738-6163
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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