Provider Information for 1366579146
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CLYMIE ALLEN LCSW
Sex: Female
NPI: 1366579146
Last Updated: 2019-12-19
Certification Date: 2019-12-19
Certification Date: 2019-12-19
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1366579146 | ||||||||
| Enumeration Date | 2007-02-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5631 S LA CIENEGA BLVD LOS ANGELES, CA 90056-1333 United States Phone: 310-613-1962 | Fax: | ||||||||
| Primary Practice Address | 5631 S LA CIENEGA BLVD LOS ANGELES, CA 90056-1333 United States Phone: 310-613-1962 | Fax: | ||||||||
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