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Individual

MR. JEFFREY J ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A.C.P.

Contact information

Practice address
133 ELM ST., MONTPELIER, VT 05602-3172
(802) 223-4342
(802) 223-7311
Mailing address
PO BOX 659, MONTPELIER, VT 05601-0659
(802) 223-4342
(802) 223-7311

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ALLE 062 9965
BLUE CROSS BLUE SHIELD
VT
01
OVN1676
VERMONT MEDICAID
VT
Enumeration date
04/26/2006
Last updated
07/08/2007
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