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Individual

TANNER WHITTAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6830 XAVIER CIR, UNIT 3, WESTMINSTER, CO 80030-5714
(303) 552-6125
Mailing address
6830 XAVIER CIR, UNIT 3, WESTMINSTER, CO 80030-5714
(303) 552-6125

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
225C00000X
Rehabilitation Counselor
372600000X
Adult Companion
373H00000X
Day Training/Habilitation Specialist
Primary
3747P1801X
Personal Care Attendant
376J00000X
Homemaker

Other

Enumeration date
04/04/2016
Last updated
04/04/2016
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