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General NPI Number Information
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NPI Number | 1669041265
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Entity Type | Individual
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Provider Name | THEODORE CRITTENDON ALLEN APC
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Gender | Male
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Dates
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Enumeration Date | 06/18/2021
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 345 W MEMORIAL DR
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City | HINESVILLE
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State | GA
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Zip | 31313-2413
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Country | US
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Telephone | 912-785-0714
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Fax |
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Provider Business Mailing Address
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Address Line | 345 W MEMORIAL DR
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City | HINESVILLE
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State | GA
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Zip | 31313-2413
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Country | US
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Telephone | 404-409-0413
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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