Individual
ELLISA VINZANT ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4120 CLEMSON BLVD, ANDERSON, SC 29621-1176
(662) 364-0465
Mailing address
108 ARCHDALE WAY, ANDERSON, SC 29621-1824
(662) 364-0465
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11675
SC
1041C0700X
Clinical Social Worker
67753
SC
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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