Talley, Jack L.

Talley, Jack L. is an sole proprietor health care provider with primary practice located at 140 E Marietta St , Canton GA 30114-3013. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Talley, Jack L. can be contacted via phone (770) 213-3594.

Contact Information

Primary practice address
140 E Marietta St Canton GA 30114-3013
Phone: (770) 213-3594
Fax: (770) 315-3595
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1489 Georgia

Profile Details

NPI number 1215348719
LBN Legal business name Talley, Jack L.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 19th, 2014
Last updated May 19th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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