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Individual

MATT ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPSS

Contact information

Practice address
565 HIGHWAY 192 W, LONDON, KY 40741-2637
(606) 224-7488
Mailing address
159 WATERWORKS RD, LONDON, KY 40741-8225
(606) 224-7488

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
288501
KY
174400000X
Specialist
KY

Other

Enumeration date
06/15/2023
Last updated
02/05/2025
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