Provider Demographics
NPI:1497539563
Name:HALLEY, ALLIE JO (PLPC)
Entity Type:Individual
Prefix:MRS
First Name:ALLIE
Middle Name:JO
Last Name:HALLEY
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:MISS
Other - First Name:ALLIE
Other - Middle Name:JO
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:820 PARK DR
Mailing Address - Street 2:
Mailing Address - City:SAINTE GENEVIEVE
Mailing Address - State:MO
Mailing Address - Zip Code:63670-1566
Mailing Address - Country:US
Mailing Address - Phone:573-883-7407
Mailing Address - Fax:
Practice Address - Street 1:820 PARK DR
Practice Address - Street 2:
Practice Address - City:SAINTE GENEVIEVE
Practice Address - State:MO
Practice Address - Zip Code:63670-1566
Practice Address - Country:US
Practice Address - Phone:573-883-7407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023032392101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health