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General NPI Number Information
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NPI Number | 1528220548
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Entity Type | Individual
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Provider Name | CHRYSAUNDRA MCCLOUD TANNER L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 1504 TAUB LOOP
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City | HOUSTON
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State | TX
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Zip | 77030-1608
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Country | US
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Telephone | 713-873-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1941 EAST RD ROON 3226
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City | HOUSTON
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State | TX
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Zip | 77054-6010
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Country | US
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Telephone | 713-486-2532
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Fax | 713-486-2553
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW36075
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License Number State | TX
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