| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MICHAEL TANNER | 1548869183 | 2020-10-24 |
Michael Tanner is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1548869183. Registration indicates Michael Tanner is a provider of services with a specialization in Behavioral Health & Social Service Providers, Marriage & Family Therapist (Marriage & Family Therapist, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Marriage & Family Therapist, Behavioral Health & Social Service Providers)
| Entity Type | Individual |
| Provider Name | Michael Tanner LMFT |
| Practice Office Address | 5763 VILLAGE LOOP FAIRBURN, GA US |
| Practice Office Telephone | 7703771563 |
| Mailing Address | 5763 VILLAGE LOOP FAIRBURN, GA 302134641 US |
| Business Telephone | 7703771563 |
| Code | Practice | License No State |
|---|---|---|
| 106H00000X PRIMARY | Behavioral Health & Social Service Providers Marriage & Family Therapist Marriage & Family Therapist Behavioral Health/Substance Abuse/Psychiatry Marriage & Family Therapist Behavioral Health & Social Service Providers | LMFT001813
GA |
| 193200000X MULT | Group Code |