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Individual

SHELLY A TACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
1605 SCHERM RD STE 1, OWENSBORO, KY 42301-5300
(270) 685-9499
(270) 685-9443
Mailing address
1605 SCHERM RD STE 1, OWENSBORO, KY 42301-5300
(270) 685-9499
(270) 685-9443

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
131137
KY

Other

Enumeration date
12/11/2019
Last updated
12/11/2019
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