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NPI Code Detail

MEDICARE: YARED ALEMU PH.D.

MEDICARE:   YARED  ALEMU  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY002938GA

General Provider Information

NPI Number : 1811003080
Entity Type Code : Individual
Provider Name (Legal Business Name) : YARED ALEMU PH.D.
Provider Business Mailing Address
First Line : 2700 CUMBERLAND PKWY SE
Second Line : SUITE 120
City : ATLANTA
State : GA
Zip : 30339-3321
Country : US
Telephone Number : 770-319-7468
Fax Number : 866-416-1767
Provider Business Practice Location Address
First Line : 2700 CUMBERLAND PKWY SE
Second Line : SUITE 120
City : ATLANTA
State : GA
Zip : 30339-3321
Country : US
Telephone Number : 770-319-7468
Fax Number : 866-416-1767
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 06/20/2011

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