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1053170365
JOSHUA WAYNE TACKETT
SOMERSET, KY
NPI
1053170365
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KY 282467)
Enumeration Date
2024-03-18
Last Update Date
2024-03-18
Business Address
JOSHUA WAYNE TACKETT CADCA
233 PARKERS MILL WAY # USA
SOMERSET, KY 42503-4152
Phone number: 606-485-9323
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Mailing Address
JOSHUA WAYNE TACKETT CADCA
375 CANTERBURY DR
SCIENCE HILL, KY 42553-7242
Phone number: 606-729-6919
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