Individual
DANETTE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1400 COLLEGE DR STE 204, TEXARKANA, TX 75503-3575
(903) 791-1110
(903) 791-9353
Mailing address
4171 N CROSSOVER RD, FAYETTEVILLE, AR 72703-4591
(479) 521-1427
(479) 521-6520
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64755
TX LICENSE
TX
01
—
6902-C
AR LICENSE
AR
Enumeration date
09/25/2013
Last updated
07/07/2022
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