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Individual

MRS. AMY THISTLE TACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
298 PATTON PKWY, MARINA, CA 93933-6007
(831) 220-1763
Mailing address
231 MCCULLOCH CIR, MARINA, CA 93933-2404
(831) 220-1763

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
21919
CA

Other

Enumeration date
06/02/2026
Last updated
06/02/2026
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