Individual
MR. BRYAN SCOTT TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
2551 E COUNTY ROAD 62E, WELLINGTON, CO 80549-1502
(318) 638-4621
Mailing address
2551 E COUNTY ROAD 62E, WELLINGTON, CO 80549-1502
(318) 638-4621
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-09-5044
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-09-5044
BACB CERTIFICATION NUMBER.
—
Enumeration date
08/11/2010
Last updated
03/15/2016
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