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Individual
TINA A TANNER
Active
Individual
TINA A TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
174400000X
Specialist
—
—
1744R1102X
Research Study Specialist
—
—
251B00000X
Case Management Agency
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
08/22/2013
Last updated
03/06/2020
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