Individual
JENNIFER CLAIRE TACKITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
561 INDIANAPOLIS RD, MOORESVILLE, IN 46158-1271
(317) 383-7097
Mailing address
561 INDIANAPOLIS RD, MOORESVILLE, IN 46158-1271
(317) 383-7097
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007261A
IN
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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