Individual
MRS. ALEXIA MICHELLE TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
911 MAIN ST S, TIFTON, GA 31794-4867
(229) 396-4689
(229) 396-4605
Mailing address
P.O. BOX 2707, TIFTON, GA 31793-0909
(229) 388-0932
(229) 388-0933
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005210
GA
Other
Enumeration date
07/14/2015
Last updated
08/02/2020
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