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Lacey Tank
NPI 1629777396 · on the registry since 2023
Practice
- Address
- 1642 Powers Ferry Rd Se Ste 100
Marietta, GA 30067 - Phone
- (770) 565-3045
- Organisation at this address
- Village Autism Center Llc
The Well Studio Therapy LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Also registered as
- 106E00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-03-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia