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NPI Code Detail

MEDICARE: MS. MARCINE JENICE ALLEN MS, LPC

MEDICARE: MS. MARCINE JENICE ALLEN MS, LPC
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
1101YP2500XProfessional CounselorLPC00496MN

General Provider Information

NPI Number : 1689819559
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARCINE JENICE ALLEN MS, LPC
Provider Business Mailing Address
First Line : 343 WOODLAKE DR SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-6242
Country : US
Telephone Number : 507-289-2089
Fax Number : 507-535-5799
Provider Business Practice Location Address
First Line : 343 WOODLAKE DR SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-6242
Country : US
Telephone Number : 507-289-2089
Fax Number : 507-535-5799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2008
Last Update Date : 12/08/2008

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