Provider Demographics
NPI:1013153071
Name:BRAATEN, ALYSSA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:BRAATEN
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:400 VILLAGE PKWY NE APT 138
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-4363
Mailing Address - Country:US
Mailing Address - Phone:612-423-1888
Mailing Address - Fax:678-985-4855
Practice Address - Street 1:2701 N DECATUR RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5918
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:678-985-4855
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2023-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAPSY003192103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist