| Tanner Lcsw, Llc | |
|
916 6th St Las Vegas NM 87701-4307 | |
| (808) 635-8057 | |
| Not Available |
| Full Name | Tanner Lcsw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 916 6th St, Las Vegas, New Mexico |
| Authorized Official Name and Position | Danita Tanner (DIRECTOR) |
| Authorized Official Contact | 8086358057 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanner Lcsw, Llc 932 Gallinas St Las Vegas NM 87701-3891 Ph: () - | Tanner Lcsw, Llc 916 6th St Las Vegas NM 87701-4307 Ph: (808) 635-8057 |
| NPI Number | 1568917730 |
|---|---|
| Provider Enumeration Date | 08/17/2016 |
| Last Update Date | 08/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568917730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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