Individual
BRIAN JEFFREY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
2626 NORTH THIRD STREET, TLC CLINIC, 2ND FLOOR, HARRISBURG, PA 17110-2044
(717) 232-5443
(717) 232-4553
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS017579
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029443740001
—
PA
Enumeration date
07/12/2007
Last updated
04/22/2019
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