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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437272945 | NPPES |
| Louisiana | MEDICAID | 1969559 |
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