Provider Demographics
NPI:1952154031
Name:AYARESA THERAPY
Entity Type:Organization
Organization Name:AYARESA THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DWUMFUOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MSW
Authorized Official - Phone:404-590-3219
Mailing Address - Street 1:2959 CHAPEL HILL RD STE D
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-3159
Mailing Address - Country:US
Mailing Address - Phone:404-590-3219
Mailing Address - Fax:
Practice Address - Street 1:2959 CHAPEL HILL RD STE D
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-3159
Practice Address - Country:US
Practice Address - Phone:404-590-3219
Practice Address - Fax:678-348-7487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty