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1912496373
JORDAN MICHAEL TANNER
EFFINGHAM, IL
NPI
1912496373
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-05-01
Last Update Date
2018-05-01
Business Address
JORDAN MICHAEL TANNER QMHP, PEL, MS
1901 S 4TH ST STE 213
EFFINGHAM, IL 62401-4188
Phone number: 217-347-5880
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Mailing Address
JORDAN MICHAEL TANNER QMHP, PEL, MS
3491 N 1300TH ST
MASON, IL 62443-2826
Phone number: 618-534-1801
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