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Individual

KRISTI LYNNE TACKETT-NEWBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD LIMHP CPC

Contact information

Practice address
9802 NICHOLAS ST STE 350, OMAHA, NE 68114-2106
(402) 932-2296
(402) 281-0665
Mailing address
9802 NICHOLAS ST STE 350, OMAHA, NE 68114-2106
(402) 932-2296
(402) 281-0665

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
293
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025043400
NE
Enumeration date
05/14/2007
Last updated
12/01/2020
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