Individual
MICHELLE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13200 MCCORMICK DR, TAMPA, FL 33626-3010
(813) 814-5971
(813) 814-5972
Mailing address
12760 WESTWOOD LAKES BLVD, TAMPA, FL 33626-2345
(813) 814-5971
(813) 814-5972
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
FL
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111184900
—
FL
Enumeration date
10/08/2019
Last updated
08/12/2021
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