Individual
ANTHONY DEWAYNE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6200 MACCORKLE AVE, SAINT ALBANS, WV 25177-2331
(304) 356-9841
Mailing address
PO BOX 11792, CHARLESTON, WV 25339-1792
(304) 356-9841
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/25/2019
Last updated
10/25/2019
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