MEDICARE: ROBERT JAMES ALLAN LMFT

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	106H00000X	Marriage & Family Therapist	0001225	CO

General Provider Information

NPI Number	:	1902272859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JAMES ALLAN LMFT

Provider Business Mailing Address
First Line	:	3800 YORK ST.
Second Line	:	INNER CITY HEALTH CENTER
City	:	DENVER
State	:	CO
Zip	:	80205-3972
Country	:	US
Telephone Number	:	303-296-1767
Fax Number	:	303-296-9313

Provider Business Practice Location Address
First Line	:	3800 YORK ST.
Second Line	:	INNER CITY HEALTH CENTER
City	:	DENVER
State	:	CO
Zip	:	80205-3972
Country	:	US
Telephone Number	:	303-296-1767
Fax Number	:

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

Provider Enumeration Date	:	08/14/2015
Last Update Date	:	08/14/2015

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