Individual
CORINNE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4646 67TH ST, SAN DIEGO, CA 92115-4204
(619) 209-9181
Mailing address
4646 67TH ST, SAN DIEGO, CA 92115-4204
(619) 209-9181
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17939
CA
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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