Individual
AMANDA KATE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
861 MSC, CHARLESTON, SC 29425-1009
(843) 792-9162
(843) 792-9163
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
(843) 792-9162
(843) 792-9163
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
LL82817
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL82817
LIMITED MEDICAL LICENSE
SC
Enumeration date
06/12/2019
Last updated
06/12/2019
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