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General NPI Number Information
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NPI Number | 1336634732
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Entity Type | Individual
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Provider Name | TANNER CURTIS TAGGART
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Gender | Male
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 09/02/2024
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Provider Practice Location Address
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Address Line | 6503 S 390 E
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City | SOUTH WEBER
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State | UT
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Zip | 84405-7240
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Country | US
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Telephone | 801-821-6417
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Fax |
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Provider Business Mailing Address
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Address Line | 6503 S 390 E
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City | SOUTH WEBER
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State | UT
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Zip | 84405-7240
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Country | US
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Telephone | 801-821-6417
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 11320502-3902
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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