Individual
MS. KRISTY TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3135 16TH STREET RD, SUITE 21, HUNTINGTON, WV 25701-5247
(304) 523-1164
(304) 522-2474
Mailing address
169 RAVENWOOD RD, HAROLD, KY 41635-9121
(606) 434-4594
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1756
WV
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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