Most Relevant Information
Provider Data
| NPI Number: | 1003175167 |
| Provider Name: | MARTIN PATTERSON TANNER LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | LCSW1639 |
Most Important Dates
| Enumeration Date: | 05/10/2012 |
| Last Updated: | 04/25/2024 |
Provider Practice Location
44648 15TH ST W
LANCASTER
CA
935342806
Practice Location Phone/Fax
| Phone: | 6614630501 |
| Fax: |
Provider Mailing Location
809 S 6TH ST
BASIN
WY
824109510
Provider Mailing Phone/Fax
| Phone: | 6614630501 |
| Fax: |