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NPI Code Detail

MEDICARE: JULIE RENEE ALLOMONG

MEDICARE: JULIE RENEE ALLOMONG
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
1103K00000XBehavior Analyst1-21-57359IN

General Provider Information

NPI Number : 1235828955
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE RENEE ALLOMONG
Provider Business Mailing Address
First Line : 101 W DUPONT RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-1915
Country : US
Telephone Number : 260-489-1774
Fax Number : 260-489-1777
Provider Business Practice Location Address
First Line : 101 W DUPONT RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-1915
Country : US
Telephone Number : 260-489-1774
Fax Number : 260-489-1777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2023
Last Update Date : 05/08/2023

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Directions to “ JULIE RENEE ALLOMONG ” Practice Location

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