Individual
ZOEY MARIE TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2103 N VETERANS PKWY, BLOOMINGTON, IL 61704-0908
(309) 948-6469
Mailing address
12 BRIARWOOD LN, ROCHESTER, IL 62563-9518
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
11/15/2025
Last updated
11/15/2025
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