Individual
MS. DEBRA TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
3275 HIGH KNOB RD, EQUALITY, IL 62934-2613
(618) 275-4313
(618) 275-4569
Mailing address
3275 HIGH KNOB RD, EQUALITY, IL 62934-2613
(618) 275-4313
(618) 275-4569
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
DT64020298P
IL
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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