Individual
AUSTIN C TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BT
Contact information
Practice address
916 COX RD STE 201, GASTONIA, NC 28054-3496
(704) 780-4271
(704) 788-2016
Mailing address
222 BRIAR CREEK RD, GASTONIA, NC 28056-8905
(912) 224-1210
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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