Individual
MARCUS CRANDALL ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCADC
Contact information
Practice address
71 CONN ST, IVEL, KY 41642
(606) 478-8500
(606) 478-8505
Mailing address
71 CONN ST, IVEL, KY 41642
(606) 478-8500
(606) 478-8505
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
175171
KY
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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