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1750719407
TERRENCE TANNER
PORTSMOUTH, VA
NPI
1750719407
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: VA 0904005040)
Enumeration Date
2013-10-16
Last Update Date
2013-10-16
Business Address
Mr. TERRENCE TANNER LCSW
4000 COAST GUARD BLVD HSWL
PORTSMOUTH, VA 23703-2135
Phone number: 757-686-4036
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Mailing Address
Mr. TERRENCE TANNER LCSW
4000 COAST GUARD BLVD HSWL
PORTSMOUTH, VA 23703-2135
Phone number: 757-686-4036
Copy
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