Provider Demographics
NPI:1245935832
Name:PALANIAPPAN, ALAGAMMAI ALLY (ALAGA PALANI, ALLY P)
Entity type:Individual
Prefix:
First Name:ALAGAMMAI
Middle Name:ALLY
Last Name:PALANIAPPAN
Suffix:
Gender:F
Credentials:ALAGA PALANI, ALLY P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BLOCK NO Q FLAT G FOURTH FLOOR
Mailing Address - Street 2:FOURTH FLOOR, KANNIPPA NAGAR
Mailing Address - City:CHENNAI
Mailing Address - State:TAMIL NADU
Mailing Address - Zip Code:600083
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:109 LEROUX ST
Practice Address - Street 2:
Practice Address - City:DONIPHAN
Practice Address - State:MO
Practice Address - Zip Code:63935-1038
Practice Address - Country:US
Practice Address - Phone:573-996-2136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021050263133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered