Provider Demographics
NPI:1578736419
Name:THERAPEUTIC EXPRESSIONS
Entity Type:Organization
Organization Name:THERAPEUTIC EXPRESSIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:FLINT
Authorized Official - Last Name:YEARBY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:404-822-8867
Mailing Address - Street 1:2759 DELK RD SE
Mailing Address - Street 2:SUITE 2700
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8847
Mailing Address - Country:US
Mailing Address - Phone:404-822-8867
Mailing Address - Fax:
Practice Address - Street 1:2759 DELK RD SE
Practice Address - Street 2:SUITE 2700
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8847
Practice Address - Country:US
Practice Address - Phone:404-822-8867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003356251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health