Individual
ANTHONY WAYNE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3995 W COOPER LAKE DR SE, SMYRNA, GA 30082-4006
(404) 889-6886
Mailing address
3995 W COOPER LAKE DR SE, SMYRNA, GA 30082-4006
(404) 358-3200
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY004330
GA
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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