MEDICARE: DR. DEMETRESS CHEEK PSYD, MBA

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
1	103TC0700X	Clinical Psychologist	PSY004471	GA

General Provider Information

NPI Number	:	1902496672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEMETRESS CHEEK PSYD, MBA

Provider Business Mailing Address
First Line	:	4175 TANNERS CREEK DR
Second Line	:
City	:	FLOWERY BRANCH
State	:	GA
Zip	:	30542-2816
Country	:	US
Telephone Number	:	404-321-6111
Fax Number	:

Provider Business Practice Location Address
First Line	:	4175 TANNERS CREEK DR
Second Line	:
City	:	FLOWERY BRANCH
State	:	GA
Zip	:	30542-2816
Country	:	US
Telephone Number	:	404-321-6111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	01/26/2021

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