Individual
MICHELE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC-AD
Contact information
Practice address
2225 N CHARLES ST, BALTIMORE, MD 21218-5778
(410) 366-4360
Mailing address
3004 FLEETWOOD AVE, BALTIMORE, MD 21214-1452
(443) 635-8079
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SC1860
MD
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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