Individual
ANDREA LASHAWN TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ABD, LPC, LMFT, LADC
Contact information
Practice address
10 SW 2ND ST STE 4, LAWTON, OK 73501-4027
(580) 512-9862
(580) 585-5890
Mailing address
PO BOX 40, FULSHEAR, TX 77441-0040
(580) 512-9862
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
354
OK
101YM0800X
Mental Health Counselor
Primary
3171
OK
106H00000X
Marriage & Family Therapist
705
LA
Other
Enumeration date
05/23/2007
Last updated
04/10/2024
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