Provider Information for 1659500882
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
MARY ALLEN LCSW
Sex: Female
NPI: 1659500882
Last Updated: 2020-04-09
Certification Date: 2020-04-09
Certification Date: 2020-04-09
Details
| Name | Value | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1659500882 | ||||||||||||||||||||
| Enumeration Date | 2009-07-09 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 113 E MAIN ST STOUGHTON, WI 53589-1720 United States Phone: 608-449-7201 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 113 E MAIN ST STOUGHTON, WI 53589-1720 United States Phone: 608-449-7201 | Fax: | ||||||||||||||||||||
| Secondary Practice Address(es) | |||||||||||||||||||||
| Health Information Exchange |
| ||||||||||||||||||||
| Other Identifiers |
| ||||||||||||||||||||
| Taxonomy |
|