| NPI | 1699925347 |
|---|---|
| Former Name | JENNIFER LYNN TANNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AK 143167) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AR 2246-C) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2019-05-19 |