Individual
MRS. MELICIA IVETTE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
139 LILA DOYLE DR, SENECA, SC 29672-9495
(864) 482-3483
(864) 482-3497
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7038
SC
101YP2500X
Professional Counselor
7038
SC
104100000X
Social Worker
Primary
7038
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301100
—
SC
Enumeration date
02/08/2016
Last updated
11/21/2023
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