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General NPI Number Information
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NPI Number | 1326191784
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Entity Type | Individual
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Provider Name | MADALYNE MARIE ALLEN LPC
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Gender | Female
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2301 KELL BLVD SUITE 215
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City | WICHITA FALLS
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State | TX
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Zip | 76308-1007
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Country | US
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Telephone | 940-322-9200
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Fax | 940-691-2159
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Provider Business Mailing Address
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Address Line | PO BOX 9286
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City | WICHITA FALLS
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State | TX
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Zip | 76308-9286
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Country | US
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Telephone | 940-322-9200
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Fax | 940-691-2458
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 17687
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License Number State | TX
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