MEDICARE: CHRISTINA JOY ALLEN LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	111036	TX

General Provider Information

NPI Number	:	1174954903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA JOY ALLEN LMSW

Provider Business Mailing Address
First Line	:	104 SYLVESTER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-1314
Country	:	US
Telephone Number	:	248-595-9097
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 S DAIRY ASHFORD RD STE 510
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-2333
Country	:	US
Telephone Number	:	713-364-8645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2013
Last Update Date	:	01/23/2024

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