Individual
TERRANCE HALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3500 HIGHWAY 5, DOUGLASVILLE, GA 30135-2315
(844) 433-3671
Mailing address
5988 LANCELOT LN, DOUGLASVILLE, GA 30135-9016
(678) 507-4113
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
GA
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003247136A
—
GA
05
—
003247136B
—
GA
05
—
003252348A
—
GA
01
—
01011975
DATE OF BIRTH
—
01
—
251C00000X
TAXONOMY CODE
GA
Enumeration date
11/07/2021
Last updated
05/11/2026
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