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1205672615
JACQUELINE A TACKETT
WOODBRIDGE, VA
NPI
1205672615
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: VA 0701013686)
Enumeration Date
2024-07-04
Last Update Date
2024-07-04
Business Address
JACQUELINE A TACKETT LPC
14844 ENSOR CT
WOODBRIDGE, VA 22193-2676
Phone number: 571-264-3165
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Mailing Address
JACQUELINE A TACKETT LPC
12531 CLIPPER DR STE 202-17
WOODBRIDGE, VA 22192-2518
Phone number: 571-264-3165
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