Provider Demographics
NPI:1295194108
Name:ORI ALAAFIA COUCHING & PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:ORI ALAAFIA COUCHING & PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:WANJIRU
Authorized Official - Last Name:NGUMBA-GATABAKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-274-0596
Mailing Address - Street 1:3485 BENEFIELD PL SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-8757
Mailing Address - Country:US
Mailing Address - Phone:919-274-0596
Mailing Address - Fax:
Practice Address - Street 1:3485 BENEFIELD PL SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-8757
Practice Address - Country:US
Practice Address - Phone:919-274-0596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003959103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty