Individual
EMMA CAITLEN TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
16643 STATE ROUTE 104, CHILLICOTHE, OH 45601-9718
(740) 775-4326
Mailing address
2100 STELLA CT, COLUMBUS, OH 43215-1011
(614) 502-7812
(614) 252-7987
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.184789
OH
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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