Individual
HOLLY K TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 S FRONT ST, ARIMO, ID 83214-7726
(208) 317-3899
Mailing address
PO BOX 29, ARIMO, ID 83214-0029
(208) 317-3899
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
ID
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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