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General NPI Number Information
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NPI Number | 1821608985
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Entity Type | Individual
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Provider Name | JOZIE ALLEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 1001 MAIN ST STE 107
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City | PEORIA
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State | IL
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Zip | 61606-1907
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Country | US
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Telephone | 309-308-0210
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Fax |
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Provider Business Mailing Address
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Address Line | 7662 N WYOMING RD
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City | WYOMING
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State | IL
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Zip | 61491-9064
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Country | US
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Telephone | 309-229-0039
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149020669
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License Number State | IL
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