Individual
COURTNEY TANNER
Active
Individual
COURTNEY TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
99440
TX
225700000X
Massage Therapist
LMT-LMT-LIC-4317
MT
225700000X
Massage Therapist
MASG-295
ID
Other
Enumeration date
11/07/2013
Last updated
11/08/2023
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