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Individual

DIAN TACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
360 PEAK ONE DR STE 110, FRISCO, CO 80443
(970) 668-3478
Mailing address
715 HORIZON DR STE 225, GRAND JUNCTION, CO 81506-8743

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
11/03/2016
Last updated
03/26/2019
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  • EDI platform