Individual
MS. BRENDA DEE TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
103 WALNUT ST, CLAYTON, NM 88415-3049
(505) 374-2032
(505) 374-0158
Mailing address
PO BOX 773, STRATFORD, TX 79084-0773
(214) 202-0485
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T-0099551
NM
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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