Individual
KYLE TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1249 15TH ST STE 2000, HUNTINGTON, WV 25701-3662
(304) 691-1000
Mailing address
1249 15TH ST, HUNTINGTON, WV 25701-3662
(304) 691-1000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
1310
WV
Other
Enumeration date
08/28/2016
Last updated
10/21/2022
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