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NPI Code Detail

MEDICARE: ALLISON COLEMAN BALLEW PH.D.

MEDICARE: ALLISON COLEMAN BALLEW PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistP2530TN
2103TC0700XClinical Psychologist3404NC

General Provider Information

NPI Number : 1972502508
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON COLEMAN BALLEW PH.D.
Provider Business Mailing Address
First Line : 9003 WESTON PKWY
Second Line : LUCY DANIELS CENTER FOR EARLY CHILDHOOD
City : CARY
State : NC
Zip : 27513-2201
Country : US
Telephone Number : 919-677-1459
Fax Number : 919-677-1489
Provider Business Practice Location Address
First Line : 9003 WESTON PKWY
Second Line : LUCY DANIELS CENTER FOR EARLY CHILDHOOD
City : CARY
State : NC
Zip : 27513-2201
Country : US
Telephone Number : 919-677-1459
Fax Number : 919-677-1489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 09/11/2007

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