| Doctor Name: | MR. MICKEY GLENN TENER |
| NPI Number: | 1215239926 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.S., LCMFT |
| License Number: | 256 |
| Business Practice Address: | 7427 Apeninnes Road Ft Riley, KS - 664427037 |
| Business Phone Number: | 7852397311 |
| Business Fax Number: | |
| Mailing Address: | 7424 Apennines Dr, FT RILEY |
| State: | KS |
| Postal Code: | 664427151 |
| Phone Number: | 7852397311 |
| Fax Number: | |
| NPI Enumeration Date: | 12/01/2010 |
| NPI Last Update Date: | 05/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 256 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |