Individual
AMY TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD
Contact information
Practice address
4229 TIMES SQUARE BLVD, DUBLIN, OH 43016-7103
(937) 247-4136
Mailing address
6156 ROCKVILLE DR, COLORADO SPRINGS, CO 80923-3806
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/11/2018
Last updated
12/27/2023
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