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1255620332
KEISHA T TANNER
MCDONOUGH, GA
NPI
1255620332
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: GA APC002881)
Enumeration Date
2011-03-29
Last Update Date
2011-03-29
Business Address
MRS. KEISHA T TANNER LAPC
338 AUTUMN LAKE DR
MCDONOUGH, GA 30253-6590
Phone number: 678-272-0713
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Mailing Address
MRS. KEISHA T TANNER LAPC
338 AUTUMN LAKE DR
MCDONOUGH, GA 30253-6590
Phone number: 678-272-0713
Copy
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