Provider Demographics
NPI:1669752069
Name:RAMIREZ-LEON, GABRIELA (PSYD)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:
Last Name:RAMIREZ-LEON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15164
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30333-0164
Mailing Address - Country:US
Mailing Address - Phone:404-242-1927
Mailing Address - Fax:
Practice Address - Street 1:805 CHURCH ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1870
Practice Address - Country:US
Practice Address - Phone:404-242-1927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003391103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist