Healthcare Provider Details

I. General information

NPI: 1467903609
Provider Name (Legal Business Name): ALESYA KOREY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 DEVONWOOD TRL NW
MARIETTA GA
30064-5439
US

IV. Provider business mailing address

821 DEVONWOOD TRL NW
MARIETTA GA
30064-5439
US

V. Phone/Fax

Practice location:
  • Phone: 404-862-8106
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY3835
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPSY3835
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY3835
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: