Individual
ALLISON THERESA HANNAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LISW
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(936) 225-2732
Mailing address
442 COUNTRY CLUB RD, LEESVILLE, LA 71446-2927
(936) 225-2732
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW007332
GA
1041C0700X
Clinical Social Worker
095868
IA
1041C0700X
Clinical Social Worker
Primary
149.020704
IL
Other
Enumeration date
10/10/2016
Last updated
10/05/2021
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