Organization
BRANDI TANNER, PH.D., LLC
Active
Organization
BRANDI TANNER, PH.D., LLC
Active
Other names
Lightway Psychological Services
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI TANNER PH.D. (OWNER)
(404) 491-1684
Entity
Organization
Contact information
Practice address
2801 BUFORD HWY NE STE 503, BROOKHAVEN, GA 30329-2137
(404) 491-1684
(844) 646-0336
Mailing address
2801 BUFORD HWY NE STE 503, BROOKHAVEN, GA 30329-2137
(404) 491-1684
(844) 646-0336
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TS0200X
School Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003151503C
—
GA
Enumeration date
01/09/2018
Last updated
01/09/2018
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