Individual
HUBERT PIERCE TANKERSLEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1815 OLD 41 HWY NW STE 110, KENNESAW, GA 30152-4422
(678) 468-9103
Mailing address
1815 OLD 41 HWY NW STE 110, KENNESAW, GA 30152-4422
(678) 468-9103
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PENDING
GA
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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