SearchOhio104100000X

Brandon Tackett, LSW

NPI 1326702572 · on the registry since 2021

Practice

Address
865 S Patterson Blvd
Dayton, OH 45402
Phone
(937) 966-4673
Clinicians at this address
196

Registry record

Primary taxonomy
104100000X
104100000X
Also registered as
106S00000X
171M00000X
175T00000X
Licence states on file
OH
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-08-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio