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Individual

ALBERT BASCOM ELMORE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1830 WATER PL SE STE 210, ATLANTA, GA 30339-2292
(770) 310-1887
Mailing address
1830 WATER PL SE STE 210, ATLANTA, GA 30339-2292

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
006541
GA

Other

Enumeration date
07/01/2019
Last updated
07/01/2019
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