Provider Demographics
NPI:1790106797
Name:EZRINE, GREER ALEXANDER (PHD, NCSP)
Entity Type:Individual
Prefix:DR
First Name:GREER
Middle Name:ALEXANDER
Last Name:EZRINE
Suffix:
Gender:F
Credentials:PHD, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11805 NORTHFALL LN STE 803
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7970
Mailing Address - Country:US
Mailing Address - Phone:404-702-2524
Mailing Address - Fax:678-505-1821
Practice Address - Street 1:11805 NORTHFALL LN STE 803
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7970
Practice Address - Country:US
Practice Address - Phone:404-702-2524
Practice Address - Fax:678-505-1821
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-18
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003498103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist