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Individual

MR. MICHAEL A. TANIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ED.S, LMFT

Contact information

Practice address
19501 W CATAWBA AVE, SUITE 205, CORNELIUS, NC 28031-4017
(704) 892-4082
(704) 892-4082
Mailing address
P.O. BOX 1187, HUNTERSVILLE, NC 28070-1187
(704) 892-4082
(704) 892-4082

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3801
NC
101YP2500X
Professional Counselor
4101
SC
106H00000X
Marriage & Family Therapist
Primary
875
NC

Other

Enumeration date
08/14/2006
Last updated
02/12/2009
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