Individual
TANNER GLEN MELIOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACMHC
Contact information
Practice address
34 S 300 E, PROVO, UT 84606-3201
(801) 850-9147
Mailing address
34 S 300 E, PROVO, UT 84606-3201
(801) 850-9147
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13455626-6009
UT
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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