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1861050247
TIMOTHY J TACKETT
GAINESVILLE, FL
NPI
1861050247
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH21312)
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2019-05-31
Last Update Date
2022-09-27
Business Address
TIMOTHY J TACKETT LMHC
4300 SW 13TH ST
GAINESVILLE, FL 32608-4006
Phone number: 352-374-5600
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Mailing Address
TIMOTHY J TACKETT LMHC
4300 SW 13TH ST # 2
GAINESVILLE, FL 32608-4006
Phone number: 352-374-5600
Copy
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