Individual
MR. MATTHEW LAMONTE ALLEN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLMFT
Contact information
Practice address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(313) 308-1400
Mailing address
4840 SHERIDAN ST, DETROIT, MI 48214-5301
(313) 878-4247
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4151000424
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4101006886
LICENSE NUMBER
MI
Enumeration date
08/01/2019
Last updated
01/15/2021
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