Individual
JUDITH TACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2514 FIRST AVE, KETCHIKAN, AK 99901-5804
(907) 225-4664
Mailing address
PO BOX 7475, KETCHIKAN, AK 99901-2475
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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