Ally, Glenn A

Ally, Glenn A is an sole proprietor health care provider with primary practice located at 155 Hospital Dr Suite 200, Lafayette LA 70503-2852. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Prescribing (Medical). Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Ally, Glenn A can be contacted via phone (337) 235-8304.

Contact Information

Primary practice address
155 Hospital Dr Suite 200 Lafayette LA 70503-2852
Phone: (337) 235-8304
Fax: (337) 235-5924
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 378MP Louisiana
Behavioral Health & Social Service Providers / Clinical 103TC0700X 378MP Louisiana
Behavioral Health & Social Service Providers / Prescribing (Medical) 103TP0016X 378MP Louisiana

Profile Details

NPI number 1437272945
LBN Legal business name Ally, Glenn A
Credentials PH.D, M.P.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 9th, 2007
Last updated Aug 30th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437272945 NPPES
Louisiana MEDICAID 1969559

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