Individual
DR. SALLY JANE RALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3406 ADLER AVE, FAIRBANKS, AK 99703
(571) 236-6823
Mailing address
3255 EDBY RD, FAIRBANKS, AK 99709-2657
(571) 236-6823
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
137972
AK
101YP2500X
Professional Counselor
178-000147
IL
103TC0700X
Clinical Psychologist
Primary
1543
AL
Other
Enumeration date
12/16/2014
Last updated
08/29/2019
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