Individual
LAURIE JOHNSON TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS, OTR/L
Contact information
Practice address
11840 COMMONWEALTH DR, LOUISVILLE, KY 40299-2309
(502) 633-1007
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
278889
KY
Other
Enumeration date
10/05/2006
Last updated
03/12/2024
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