Individual
MRS. DOROTHY TEBBUTT ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPA
Contact information
Practice address
1725 SOUTH MAIN STREET, SUITE 202, WAKE FOREST, NC 27587
(919) 556-6501
(919) 556-4933
Mailing address
525 RAYBURN AVE, WAKE FOREST, NC 27587
(919) 818-8249
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2045
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046MH
NC HEALTH CHOICE
NC
05
—
6107138
—
NC
01
—
8375
FIVE COUNTY MENTAL HEALTH
NC
Enumeration date
08/31/2006
Last updated
07/08/2007
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