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Individual

MICHELLE WALLACE ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
13424 WELBY CT, MIDLOTHIAN, VA 23113-3662
(804) 986-7224
Mailing address
1705 HEADWATERS RD, MIDLOTHIAN, VA 23113-4033
(804) 379-4014

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119001250
VA

Other

Enumeration date
01/31/2007
Last updated
07/08/2007
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