Individual
MS. HEATHER TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A, CCC-SLP
Contact information
Practice address
13962 KY ROUTE 979, BEAVER, KY 41604-9015
(606) 587-2662
Mailing address
13962 KY ROUTE 979, BEAVER, KY 41604-9015
(606) 587-2662
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2692
KY
Other
Enumeration date
05/17/2009
Last updated
05/17/2009
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