Provider Demographics
NPI:1679979017
Name:DONNELLY, ALLISON BALLAY (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:BALLAY
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:ALLISON
Other - Middle Name:MARY
Other - Last Name:BALLAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:870 ARGONNE AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308
Mailing Address - Country:US
Mailing Address - Phone:281-702-6715
Mailing Address - Fax:
Practice Address - Street 1:1626 JEURGENS CT.
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093
Practice Address - Country:US
Practice Address - Phone:770-279-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-12
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008647235Z00000X
GASLP0086497235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist