Individual
JOHANNA MARIE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1102 ROSE HILL DR, CHARLOTTESVILLE, VA 22903-5128
(434) 979-8628
Mailing address
2185 N LAKESHORE DR, LOUISA, VA 23093-7002
(540) 967-3835
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
04396
MD
235Z00000X
Speech-Language Pathologist
Primary
2202003003
VA
Other
Enumeration date
11/10/2008
Last updated
04/17/2025
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