Mary Kaye Tacker PHD, LMFT, LADC

NPI 1629269626 - Counselor - 101YA0400X

NPI Details
NPI 1629269626
Gender Female
Enumeration Date 08/05/2007
Last Updated 01/18/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
1406 6TH AVENUE NORTH
ST. CLOUD HOSPITAL
ST. CLOUD MN, 56303-1901, US
Phone (320) 251-2700
Fax (320) 229-5109
Business Location
1900 CENTRACARE CIR # 2475
CENTRA CARE HEALTH PLAZA
SAINT CLOUD MN, 56303-5000, US
Phone (320) 229-5199
Fax (320) 229-5109
Toxanomy
Taxonomy Code 101YA0400X
License State Minnesota
License Number 301691
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According to our database, Mary Kaye Tacker PHD, LMFT, LADC NPI is 1629269626, taxonomy code is 101YA0400X and license number is 301691, license state is located at Minnesota. Mary Kaye Tacker PHD, LMFT, LADC physically located at 1406 6th Avenue North, St. Cloud MN, 56303-1901. NPI Number Mary Kaye Tacker PHD, LMFT, LADC has the Individual type.

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1629269626 NPI number is provided on an as is basis without warranty of any kind. 1629269626 is maintained by the National Plan & Provider Enumeration System. The contents of Mary Kaye Tacker PHD, LMFT, LADC are for informational purposes only.