Individual
MS. AMY ELIZABETH TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1215 NW 25TH ST, OKLAHOMA CITY, OK 73106-5629
(405) 525-2525
(405) 524-3549
Mailing address
1215 NW 25TH ST, OKLAHOMA CITY, OK 73106-5629
(405) 525-2525
(405) 524-3549
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4454
OK
106S00000X
Behavior Technician
Primary
—
—
171W00000X
Contractor
—
—
Other
Enumeration date
01/14/2009
Last updated
12/21/2017
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