Provider / Organization | NPI | Date Certified |
---|---|---|
TANNER FONJWENG | 1649932336 | 2021-10-10 |
Tanner Fonjweng is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1649932336. Registration indicates Tanner Fonjweng is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
Entity Type | Individual |
Provider Name | Tanner Fonjweng |
Practice Office Address | 4023 KENNETT PIKE # 988 WILMINGTON, DE US |
Practice Office Telephone | 4845779928 |
Mailing Address | 31 WHITE BIRCH BLVD BEAR, DE 197014121 US |
Business Telephone | 3025076742 |
Code | Practice | License No State |
---|---|---|
106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician |