Individual
LINDA TACKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C.0501204
OH
101YM0800X
Mental Health Counselor
C.0501204
OH
101YP2500X
Professional Counselor
Primary
C.0501204
OH
101YS0200X
School Counselor
C.0501204
OH
103K00000X
Behavior Analyst
C.0501204
OH
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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