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General NPI Number Information
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NPI Number | 1457758229
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Entity Type | Individual
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Provider Name | KIRSTEN ALLEN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 11/22/2014
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 80 PEACHTREE PARK DR NE
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City | ATLANTA
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State | GA
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Zip | 30309-1304
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Country | US
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Telephone | 404-603-4314
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Fax |
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Provider Business Mailing Address
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Address Line | 1685 BRIARCLIFF RD NE APT 6
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City | ATLANTA
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State | GA
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Zip | 30306-2127
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Country | US
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Telephone | 859-552-7367
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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 | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | 004309
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License Number State | GA
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