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General NPI Number Information
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NPI Number | 1396122198
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Entity Type | Individual
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Provider Name | DEBORAH BERNETTA ALLEN LGPC
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Gender | Female
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 1282 SMALLWOOD DR W # 317
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City | WALDORF
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State | MD
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Zip | 20603-4732
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Country | US
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Telephone | 202-465-1323
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Fax | 240-607-2776
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Provider Business Mailing Address
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Address Line | 1282 SMALLWOOD DR W # 317
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City | WALDORF
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State | MD
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Zip | 20603-4732
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Country | US
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Telephone | 240-416-6836
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Fax | 240-448-3876
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC7339
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License Number State | MD
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