Individual
LOREN TACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8101 BOAT CLUB RD, SUITE 160, FORT WORTH, TX 76179-3630
(214) 302-9725
(214) 935-2457
Mailing address
8101 BOAT CLUB RD, SUITE 160, FORT WORTH, TX 76179-3630
(214) 302-9725
(214) 935-2457
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
40010
TX
Other
Enumeration date
01/07/2017
Last updated
01/07/2017
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