Andre Edward Tanner, Peer Specialist
Counselor in Brooklyn, NY. Individual provider (NPI-1).
NPI number1760191985
StatusActive
Last updated in NPPESNov 16, 2022
Details
- NPI
- 1760191985
- Entity type
- Individual (NPI-1)
- Name
- Andre Edward Tanner
- Credential
- Peer Specialist
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 16, 2022
- Certification date
- Nov 10, 2022
- Last updated
- Nov 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
2037 Utica AveBrooklyn, NY 11234-3234
Phone 718-377-7757 · Fax 718-758-9497
Mailing address
2037 Utica AveBrooklyn, NY 11234-3234
Phone 718-377-7757 · Fax 718-758-9497
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