Individual
MS. CAROLYN JO ANN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3609 GREENWOOD DR, PORTSMOUTH, VA 23701-3340
(678) 933-6437
Mailing address
3609 GREENWOOD DR, PORTSMOUTH, VA 23701-3340
(678) 933-6437
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
446401-001
VA
Other
Enumeration date
12/22/2023
Last updated
12/22/2023
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