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Individual

DR. JANE IRBY ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
445 3RD AVE SW, ALBANY, OR 97321-2272
(541) 967-3866
Mailing address
445 3RD AVE SW, ALBANY, OR 97321-2272
(541) 967-3866

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1703
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1703
STATE PSYCHOLOGIST LICENS
OR
Enumeration date
03/16/2007
Last updated
07/08/2007
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