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Individual

MR. TERRENCE TANNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
4000 COAST GUARD BLVD, HSWL, PORTSMOUTH, VA 23703-2135
(757) 686-4036
(757) 686-4094
Mailing address
4000 COAST GUARD BLVD, HSWL, PORTSMOUTH, VA 23703-2135
(757) 686-4036
(757) 686-4094

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904005040
VA

Other

Enumeration date
10/16/2013
Last updated
10/16/2013
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