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General NPI Number Information
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NPI Number | 1245775584
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Entity Type | Individual
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Provider Name | CHRISTIAN ALLEN
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Gender | Female
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Dates
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Enumeration Date | 12/22/2016
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 29193 BEECH ST
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City | INKSTER
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State | MI
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Zip | 48141-2003
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Country | US
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Telephone | 734-895-8996
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Fax |
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Provider Business Mailing Address
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Address Line | 3604 PRATT LAKE RD
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City | GLADWIN
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State | MI
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Zip | 48624-9668
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Country | US
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Telephone | 989-578-2821
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | A450115603169
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License Number State | MI
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