Provider Demographics
NPI:1871811638
Name:OAKLEY-TAITT, KATHY (CADC)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:OAKLEY-TAITT
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:OAKLEY HUITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3500 VILLA PT STE 110
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-7826
Mailing Address - Country:US
Mailing Address - Phone:270-228-2368
Mailing Address - Fax:270-478-4926
Practice Address - Street 1:3500 VILLA PT STE 110
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-7826
Practice Address - Country:US
Practice Address - Phone:270-228-2368
Practice Address - Fax:270-478-4926
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY172723101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)