Individual
JENNIE ANN TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
200 BUTTERCUP CREEK BLVD, STE. 122, CEDAR PARK, TX 78613-3708
(512) 219-8890
(512) 258-0090
Mailing address
2602 SILVER SPUR LN, LEANDER, TX 78641-7885
(512) 535-2349
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
112044
TX
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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