Individual
FRED ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
28 E RAHN RD, SUTIE 105, KETTERING, OH 45429-5461
(937) 434-6840
(937) 264-1101
Mailing address
631 KENWOOD AVE., CLAYTON, OH 45415
(937) 277-1592
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
I-7931
OH
Other
Enumeration date
07/18/2006
Last updated
07/19/2007
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