Individual
KAYLA TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 968-1298
(479) 890-5364
Mailing address
110 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 967-5570
(479) 890-5364
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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