Individual
KRISTIN TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
132 EDINBOROUGH CIR APT 2, GREENWOOD, SC 29649-1342
(740) 222-9140
Mailing address
132 EDINBOROUGH CIR APT 2, GREENWOOD, SC 29649-1342
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5463
SC
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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