Provider Demographics
NPI:1003016684
Name:ALLSOPP, RALPH NORMAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:NORMAN
Last Name:ALLSOPP
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:RALPH
Other - Middle Name:NORMAN
Other - Last Name:ALLSOPP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:5590 LONG ISLAND DR NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4861
Mailing Address - Country:US
Mailing Address - Phone:404-909-2398
Mailing Address - Fax:404-256-9121
Practice Address - Street 1:5590 LONG ISLAND DR NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4861
Practice Address - Country:US
Practice Address - Phone:404-909-2398
Practice Address - Fax:404-256-9121
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00851103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00277582AMedicaid