Provider Demographics
NPI:1972502508
Name:BALLEW, ALLISON COLEMAN (PHD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:COLEMAN
Last Name:BALLEW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9003 WESTON PKWY
Mailing Address - Street 2:LUCY DANIELS CENTER FOR EARLY CHILDHOOD
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2201
Mailing Address - Country:US
Mailing Address - Phone:919-677-1459
Mailing Address - Fax:919-677-1489
Practice Address - Street 1:9003 WESTON PKWY
Practice Address - Street 2:LUCY DANIELS CENTER FOR EARLY CHILDHOOD
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2201
Practice Address - Country:US
Practice Address - Phone:919-677-1459
Practice Address - Fax:919-677-1489
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2530103TC0700X
NC3404103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3585771Medicare ID - Type Unspecified