Tia Nichole Tackett
Behavior Technician in Muncie, IN. Individual provider (NPI-1).
NPI number1619708906
StatusActive
Last updated in NPPESAug 9, 2024
Details
- NPI
- 1619708906
- Entity type
- Individual (NPI-1)
- Name
- Tia Nichole Tackett
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 9, 2024
- Certification date
- Aug 9, 2024
- Last updated
- Aug 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
2101 W Enterprise AveMuncie, IN 47304-5839
Phone 765-892-7140
Mailing address
2101 W Enterprise AveMuncie, IN 47304-5839
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