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General NPI Number Information
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NPI Number | 1033440227
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Entity Type | Organization
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Legal Business Name | ALLEMAGNE COUNSELING & CONSULTATION SERVICES,
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 08/07/2012
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Provider Practice Location Address
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Address Line | 2916 MARKETPLACE DRIVE SUITE # 212
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City | FITCHBURG
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State | WI
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Zip | 53719-5327
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Country | US
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Telephone | 608-325-9500
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Fax | 888-345-6310
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Provider Business Mailing Address
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Address Line | 2916 MARKETPLACE DRIVE SUITE # 212
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City | FITCHBURG
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State | WI
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Zip | 53719-5327
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Country | US
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Telephone | 608-325-9500
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Fax | 888-345-6310
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN L ALLEMAGNE
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Credential | PH.D.
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Telephone | 608-325-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 166000551
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 761124
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License Number State | WI
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