Individual
MRS. TONYA LAVERN HACKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1069 E HWY 92, PINE KNOT, KY 42635-0956
(606) 354-4053
Mailing address
P.O. BOX 956, PINE KNOT, KY 42635-0956
(606) 354-4053
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/07/2010
Last updated
10/07/2010
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