Individual
HEATHER TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
2501 SHELBY RD, LA CROSSE, WI 54601-8037
(608) 788-5700
Mailing address
415 N L ST, SPARTA, WI 54656-1639
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2802-154
WI
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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