Individual
JESSIE TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
540 CHAMA ST NE, ALBUQUERQUE, NM 87108-3594
(505) 265-0753
Mailing address
540 CHAMA ST NE, ALBUQUERQUE, NM 87108-3594
(505) 265-0753
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0181571
NM
Other
Enumeration date
04/04/2016
Last updated
08/12/2019
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