Healthcare Provider Details

I. General information

NPI: 1427986934
Provider Name (Legal Business Name): CHRISTINE DAWN TANNER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

684 WARDEN AVE UNIT 118
TORONTO ON
M1L4W4
CA

IV. Provider business mailing address

684 WARDEN AVE UNIT 118
TORONTO ON
M1L4W4
CA

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-30551
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: