Healthcare Provider Details

I. General information

NPI: 1841708831
Provider Name (Legal Business Name): KATHRYN ANNE ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2018
Last Update Date: 01/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5021 CAMERON RD
BIRMINGHAM AL
35242-3902
US

IV. Provider business mailing address

5021 CAMERON RD
BIRMINGHAM AL
35242
US

V. Phone/Fax

Practice location:
  • Phone: 515-570-6941
  • Fax:
Mailing address:
  • Phone: 515-570-6941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: