Provider Demographics
NPI:1609017649
Name:FERRIS-YANKUS, LEAH MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:MARIE
Last Name:FERRIS-YANKUS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 SHADOWROCK DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-3034
Mailing Address - Country:US
Mailing Address - Phone:770-509-8266
Mailing Address - Fax:770-509-8966
Practice Address - Street 1:3901 ROSWELL RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8809
Practice Address - Country:US
Practice Address - Phone:770-509-8266
Practice Address - Fax:770-509-8966
Is Sole Proprietor?:No
Enumeration Date:2009-03-22
Last Update Date:2009-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2179103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist