| Doctor Name: | DR. KRISTINE MARIE TANNER |
| NPI Number: | 1154537538 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 47913364102 |
| Business Practice Address: | 729 Arapeen Dr Camt Building, Voice Disorders Center Salt Lake City, UT - 841081218 |
| Business Phone Number: | 8015873548 |
| Business Fax Number: | |
| Mailing Address: | 10287 Calla Lily Way, SANDY |
| State: | UT |
| Postal Code: | 840924374 |
| Phone Number: | 8015873548 |
| Fax Number: | |
| NPI Enumeration Date: | 05/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 47913364102 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |