Individual
MS. ELLEN KAY TANNEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
6801 SYLVALE CT, BALTIMORE, MD 21209-1622
(410) 805-9732
Mailing address
6801 SYLVALE CT, BALTIMORE, MD 21209-1622
(410) 486-2612
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LC4052
MD
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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