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Contact Information

BRANDI TANNER, PH.D., LLC
2801 BUFORD HWY NE STE 503
BROOKHAVEN, GA30329-2137
 Phone: 404-491-1684
 Fax: 844-646-0336
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Professional

101YP2500X
 

School

103TS0200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BRANDI TANNER, PH.D., LLC

NPI # 1871000117
LBN Legal business name BRANDI TANNER, PH.D., LLC
Authorized official BRANDI TANNER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/09/2018
Last updated 01/09/2018 - About 8 years ago
Identifiers
GA Medicaid 003151503C
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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