Provider Demographics
NPI:1659565182
Name:ALHADEFF, ALISON SEDGWICK (PT)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:SEDGWICK
Last Name:ALHADEFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 SUNSET DR # 102
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30597-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:159 SUNSET DR # 102
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30597-0001
Practice Address - Country:US
Practice Address - Phone:706-482-2268
Practice Address - Fax:706-482-2294
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009116225100000X
NCP11852225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC151C2OtherBLUE CROSS BLUE SHIELD
NC7212531Medicaid