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Individual

MS. ANGELA LOUISE TANNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A, LPC, LCMHC, LAC

Contact information

Practice address
2375 E MAIN ST STE A101, SPARTANBURG, SC 29307-1400
(864) 415-8640
(864) 415-8640
Mailing address
344 ROBIN HELTON DR, BOILING SPRINGS, SC 29316-5380
(864) 415-8640
(864) 541-7999

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
336
SC
101YP2500X
Professional Counselor
Primary
4864
SC
101YP2500X
Professional Counselor
6631
NC

Other

Enumeration date
06/26/2007
Last updated
06/21/2022
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