Individual
GREG TACKACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 TALLMADGE CIR, TALLMADGE, OH 44278
(330) 824-1014
Mailing address
30 TALLMADGE CIR, TALLMADGE, OH 44278
(330) 824-1014
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1700729-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I.1700729-SUPV
COUNSELING, SOCIAL WORK, MARRIAGE AND FAMILY THERAPIST BOARD
OH
Enumeration date
04/12/2017
Last updated
11/07/2022
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