Individual
MARY MARLENE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHTP
Contact information
Practice address
1317 N 148TH PLZ, OMAHA, NE 68154-1118
(402) 740-5510
Mailing address
1317 N 148TH PLZ, OMAHA, NE 68154-1118
(402) 740-5510
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3409
CO
Other
Enumeration date
04/22/2016
Last updated
04/22/2016
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