Healthcare Provider Details

I. General information

NPI: 1164331153
Provider Name (Legal Business Name): ALEAH RYALS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3372 PEACHTREE RD NE STE 115
ATLANTA GA
30326-1963
US

IV. Provider business mailing address

2950 RICHMOND ROW DRIVE
SUWANEE GA
30024
US

V. Phone/Fax

Practice location:
  • Phone: 404-574-6489
  • Fax:
Mailing address:
  • Phone: 404-993-4114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-272335
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: