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NPI Code Detail

MEDICARE: ALLISON DETLOFF

MEDICARE:   ALLISON  DETLOFF
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
1101YM0800XMental Health Counselor92844TX

General Provider Information

NPI Number : 1568247559
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON DETLOFF
Provider Business Mailing Address
First Line : 6951 VIRGINIA PKWY STE 315
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-5407
Country : US
Telephone Number : 469-712-9134
Fax Number : 469-375-2485
Provider Business Practice Location Address
First Line : 6951 VIRGINIA PKWY STE 315
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-5407
Country : US
Telephone Number : 469-712-9134
Fax Number : 469-375-2485
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2023
Last Update Date : 04/03/2026

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