Individual
EBONY TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
13313 CRYSTAL AVE, GRANDVIEW, MO 64030-3338
(816) 853-7273
(816) 765-7002
Mailing address
13313 CRYSTAL AVE, GRANDVIEW, MO 64030-3338
(816) 853-7273
(816) 765-7002
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2011004782
MO
Other
Enumeration date
12/13/2012
Last updated
08/06/2013
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