Provider Demographics
NPI:1366690414
Name:TANNER, RHEBECCA REIGERS (MA, CACII)
Entity Type:Individual
Prefix:MRS
First Name:RHEBECCA
Middle Name:REIGERS
Last Name:TANNER
Suffix:
Gender:F
Credentials:MA, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1252
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-1252
Mailing Address - Country:US
Mailing Address - Phone:864-582-2959
Mailing Address - Fax:864-582-0431
Practice Address - Street 1:187 W BROAD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3234
Practice Address - Country:US
Practice Address - Phone:864-582-2959
Practice Address - Fax:864-582-0431
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11020122101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)