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NPI Code Detail

MEDICARE: AMY A ALLEN BA, R-AAC

MEDICARE: AMY A ALLEN BA, R-AAC
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
1101Y00000XCounselorCG60547866WA
2101YM0800XMental Health CounselorCG 60547866WA

General Provider Information

NPI Number : 1265986954
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY A ALLEN BA, R-AAC
Provider Business Mailing Address
First Line : PO BOX 2394
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-8455
Country : US
Telephone Number : 360-200-5419
Fax Number : 360-200-6736
Provider Business Practice Location Address
First Line : 1400 COMMERCE AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-3756
Country : US
Telephone Number : 360-998-2047
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2016
Last Update Date : 08/15/2024

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Directions to “ AMY A ALLEN BA, R-AAC” Practice Location

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