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Individual

TESIA LASHAE ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3660 S COX AVE APT 1608, SPRINGFIELD, MO 65807-6934
(417) 689-0992
Mailing address
3660 S COX AVE APT 1608, SPRINGFIELD, MO 65807-6934

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MO

Other

Enumeration date
01/29/2024
Last updated
01/29/2024
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