Tanner, Andrus

Tanner, Andrus is an individual health care provider with primary practice located at 4717 E Mcdowell Rd , Phoenix AZ 85008-4544. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Tanner, Andrus can be contacted via phone (252) 266-1478.

Contact Information

Primary practice address
4717 E Mcdowell Rd Phoenix AZ 85008-4544
Phone: (252) 266-1478
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1497465769
LBN Legal business name Tanner, Andrus
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2022
Last updated Nov 28th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497465769 NPPES
Arizona MEDICAID 106847

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