Healthcare Provider Details

I. General information

NPI: 1467556670
Provider Name (Legal Business Name): ANNE M ALLEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5833 RICHMOND TAPPAHANNOCK HWY SUITE 108-B
AYLETT VA
23009-3007
US

IV. Provider business mailing address

PO BOX 284
AYLETT VA
23009-0284
US

V. Phone/Fax

Practice location:
  • Phone: 804-769-7971
  • Fax: 804-769-0714
Mailing address:
  • Phone: 804-769-7971
  • Fax: 804-769-0714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701003219
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: