Individual
ASHLEY TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 MILLARD FARMER IND BLVD STE 100, NEWNAN, GA 30263-3168
(470) 400-3177
Mailing address
10175 FORTUNE PKWY UNIT 903, JACKSONVILLE, FL 32256-6755
(904) 538-0713
(904) 538-0714
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-35318
GA
Other
Enumeration date
12/01/2016
Last updated
02/12/2020
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