Individual
AMANDA ELIZABETH TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, NCC
Contact information
Practice address
47 MT. MAHOGANY, GALLUP, NM 87301
(505) 879-9938
Mailing address
PO BOX 4837, GALLUP, NM 87305-4837
(505) 879-9938
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CTB-2025-0696
NM
Other
Enumeration date
03/11/2024
Last updated
03/06/2026
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