Individual
BETHANY TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
2267 VILLAGE MALL DR UNIT 2, ONTARIO, OH 44906-1369
(419) 951-2020
Mailing address
2267 VILLAGE MALL DR UNIT 2, ONTARIO, OH 44906-1369
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S.2410943
OH
Other
Enumeration date
05/01/2025
Last updated
05/01/2025
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