Provider Demographics
NPI:1811724933
Name:KORFAS, CLAIRE KATHRYN (MED BCBA)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:KATHRYN
Last Name:KORFAS
Suffix:
Gender:F
Credentials:MED BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 OLDE TOWNE PKWY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-5645
Mailing Address - Country:US
Mailing Address - Phone:770-330-0705
Mailing Address - Fax:
Practice Address - Street 1:4901 OLDE TOWNE PKWY
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-5645
Practice Address - Country:US
Practice Address - Phone:678-580-3997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-24-75618103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst