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1306604863
AMANDA ELIZABETH TANNER
GALLUP, NM
NPI
1306604863
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NM CTB-2023-0077)
Enumeration Date
2024-03-11
Last Update Date
2024-03-11
Business Address
AMANDA ELIZABETH TANNER MA
515 PARK AVE
GALLUP, NM 87301-5806
Phone number: 505-879-9938
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Mailing Address
AMANDA ELIZABETH TANNER MA
PO BOX 4837
GALLUP, NM 87305-4837
Phone number: 505-879-9938
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