Individual
ANTHONY JEROME ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AAS., CAC II
Contact information
Practice address
12010 LINWOOD ST, DETROIT, MI 48206-1108
(313) 867-1090
(313) 867-0706
Mailing address
5113 BANGOR ST, DETROIT, MI 48210-1760
(313) 867-1090
(313) 867-0706
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
820202
MI
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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