Provider Demographics
NPI:1811003080
Name:ALEMU, YARED (PHD)
Entity Type:Individual
Prefix:
First Name:YARED
Middle Name:
Last Name:ALEMU
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 CUMBERLAND PKWY SE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3321
Mailing Address - Country:US
Mailing Address - Phone:770-319-7468
Mailing Address - Fax:866-416-1767
Practice Address - Street 1:2700 CUMBERLAND PKWY SE
Practice Address - Street 2:SUITE 120
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3321
Practice Address - Country:US
Practice Address - Phone:770-319-7468
Practice Address - Fax:866-416-1767
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002938103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical