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NPI Code Detail

MEDICARE: JAMES ALLEN JR. LPE

MEDICARE:   JAMES  ALLEN JR. LPE
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
1101YM0800XMental Health Counselor10-17AEAR

General Provider Information

NPI Number : 1578846713
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES ALLEN JR. LPE
Provider Business Mailing Address
First Line : 829 HALBERT ST
Second Line :
City : MALVERN
State : AR
Zip : 72104-2607
Country : US
Telephone Number : 501-332-4400
Fax Number : 501-332-4403
Provider Business Practice Location Address
First Line : 4620 W COMMERCIAL DR
Second Line : SUITE C
City : NORTH LITTLE ROCK
State : AR
Zip : 72116-7057
Country : US
Telephone Number : 501-753-8400
Fax Number : 501-753-8401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2011
Last Update Date : 09/23/2011

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