Provider Demographics
NPI:1205036779
Name:ALLAN, WESLEY D (PHD)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:D
Last Name:ALLAN
Suffix:
Gender:M
Credentials:PHD
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 26170
Mailing Address - Street 2:UNCG CAMPUS
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27402-6170
Mailing Address - Country:US
Mailing Address - Phone:336-334-5662
Mailing Address - Fax:
Practice Address - Street 1:355 EBERHART BLDG
Practice Address - Street 2:UNCG CAMPUS
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27412-6170
Practice Address - Country:US
Practice Address - Phone:336-334-5662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3152103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical