Lacey Tank

NPI 1629777396 · on the registry since 2023

Practice

Address: 1642 Powers Ferry Rd Se Ste 100
Marietta, GA 30067
Phone: (770) 565-3045
Organisation at this address: Village Autism Center Llc
The Well Studio Therapy Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 4

Registry record

Primary taxonomy: Behavior Analyst
103K00000X
Also registered as: Assistant Behavior Analyst
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2023-03-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia