Provider Demographics
NPI:1790095925
Name:DELANEY, ALLEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:DELANEY
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 1:1192 PELICAN LN SE
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:GA
Mailing Address - Zip Code:31331-3516
Mailing Address - Country:US
Mailing Address - Phone:912-577-8887
Mailing Address - Fax:
Practice Address - Street 1:1192 PELICAN LN SE
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:GA
Practice Address - Zip Code:31331-3516
Practice Address - Country:US
Practice Address - Phone:912-577-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005915101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional