Individual
MRS. DEDRIA KAY TANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
140 CR 2683 -- GUN STREET, RYE, TX 77369
(936) 274-4649
(936) 274-4649
Mailing address
PO BOX 126, VOTAW, TX 77376-0126
(936) 274-4649
(936) 274-4649
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
41790
TX
251B00000X
Case Management Agency
41790
TX
Other
Enumeration date
10/14/2009
Last updated
10/16/2009
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