Individual
LEANNE NICOLE TACKTILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
501 VILLAGE AVE STE 204, YORKTOWN, VA 23693-5657
(757) 568-5904
Mailing address
501 VILLAGE AVE STE 204, YORKTOWN, VA 23693-5657
(757) 568-5904
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0906014749
VA
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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