Individual
MICHAEL ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAC
Contact information
Practice address
1099 N MERIDIAN ST, INDIANAPOLIS, IN 46204-1075
(317) 988-1413
Mailing address
1099 N MERIDIAN ST, INDIANAPOLIS, IN 46204-1075
(317) 988-1413
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87999108A
IN
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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