KETURAH TACKETT

Counselor - Addiction (Substance Use Disorder)

Active Individual
NPI: 1003158346

Practice Address

1490 GRIMES ST
Fallon, NV 89406

Phone: (775) 423-1412

Specialties

Specialty Code Primary License
Counselor - Addiction (Substance Use Disorder) 101YA0400X Yes 00179-C (NV)
Rehabilitation Practitioner 225400000X No -

Frequently Asked Questions

NPI 1003158346 is the National Provider Identifier for KETURAH TACKETT, a Counselor - Addiction (Substance Use Disorder) provider located in Fallon, NV. This NPI was enumerated on March 25, 2013.
KETURAH TACKETT practices at 1490 GRIMES ST, Fallon, NV 89406.

Quick Facts

NPI
1003158346
Type
Individual
Enumerated
Mar 25, 2013
Last Updated
Mar 25, 2013

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