Stephanie Lynn Tackett

NPI #1962927301 in Venice, Florida

Provider Information

NPI Number: 1962927301
Entity Type: Individual
Name: Stephanie Lynn Tackett
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Aug 7, 2017
Last Updated: Feb 21, 2025

Practice Location

Address: 19503 S WEST VILLAGES PKWY STE 11
City: Venice
State: Florida
ZIP Code: 34293-5108
Phone: (813) 720-7529

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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