Doctor Name: | MICHELE TANNER |
NPI Number: | 1003822180 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 5348309-3501 |
Business Practice Address: | 934 S Main St Layton, UT - 840417135 |
Business Phone Number: | 8017737060 |
Business Fax Number: | |
Mailing Address: | 934 S Main St, LAYTON |
State: | UT |
Postal Code: | 840417135 |
Phone Number: | 8017737060 |
Fax Number: | |
NPI Enumeration Date: | 07/31/2006 |
NPI Last Update Date: | 06/13/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 5348309-3501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |