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NPI Code Detail

MEDICARE: MS. KRISTEN ELIZABETH ALLEN LCSW

MEDICARE: MS. KRISTEN ELIZABETH ALLEN LCSW
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
1104100000XSocial Worker
21041C0700XClinical Social Worker53696TX

General Provider Information

NPI Number : 1194809475
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTEN ELIZABETH ALLEN LCSW
Provider Business Mailing Address
First Line : 30 PRAIRIE OAK DR
Second Line :
City : CONROE
State : TX
Zip : 77385-3753
Country : US
Telephone Number : 530-400-9347
Fax Number :
Provider Business Practice Location Address
First Line : 4950 MEMORIAL DR
Second Line :
City : HOUSTON
State : TX
Zip : 77007-7440
Country : US
Telephone Number : 713-730-2335
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 07/15/2010

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