Individual
MISS MICHELLE LYNN TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2 MANHATTANVILLE RD, PURCHASE, NY 10577-2113
(800) 835-2362
Mailing address
1107 NANTICOKE ST, BALTIMORE, MD 21230-1918
(804) 389-7916
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701007600
VA
Other
Enumeration date
04/19/2018
Last updated
08/23/2021
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