Individual
DETERRENCE DEON ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., BCBA, LBA
Contact information
Practice address
2651 MADELINE LN, SOUTHAVEN, MS 38672-6094
(334) 524-6785
Mailing address
2651 MADELINE LN, SOUTHAVEN, MS 38672-6094
(334) 524-6785
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1217
TN
103K00000X
Behavior Analyst
Primary
180045
MS
103K00000X
Behavior Analyst
2022-550
AL
Other
Enumeration date
02/19/2018
Last updated
05/03/2023
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