Individual
DANITA TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1235 EIGHTH ST., EL CENTRO FAMILY HEALTH LAS VEGAS CLINIC, LAS VEGAS, NM 87701-4219
(505) 425-6788
(505) 425-5408
Mailing address
538 N PASEO DE ONATE, P.O. BOX 158, ESPANOLA, NM 87532-2618
(505) 753-7218
(505) 753-5815
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-08229
NM
Other
Enumeration date
10/31/2006
Last updated
07/09/2013
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