Individual
BARBARA TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 22ND ST, ASHLAND, KY 41101-7803
(606) 324-1141
(606) 235-8606
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0910
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000504334
ANTHEM BCBS
—
05
—
30610026
—
KY
Enumeration date
09/25/2006
Last updated
11/10/2014
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