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General NPI Number Information
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NPI Number | 1023885860
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Entity Type | Organization
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Legal Business Name | ALLEN MIND BODY & SPIRIT HEALTH, PLLC
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 735 N LOGAN AVE
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City | DANVILLE
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State | IL
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Zip | 61832-4369
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Country | US
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Telephone | 765-585-3725
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Fax |
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Provider Business Mailing Address
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Address Line | 508 FANCY ST
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City | COVINGTON
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State | IN
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Zip | 47932-1439
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Country | US
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Telephone | 765-585-3725
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Fax |
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Authorized Official
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Title or Position | MHNP
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Name | MONICA LYNN ALLEN
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Credential | FNP AND MHNP
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Telephone | 765-585-3725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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