Individual
MR. ALLEN BOHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
347 MIDWAY BLVD, SUITE 204, ELYRIA, OH 44035-9006
(440) 324-4980
(440) 324-4987
Mailing address
3737 LANDER RD, CLEVELAND, OH 44124-5712
(216) 821-2255
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S.1450488
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2871101
—
OH
Enumeration date
08/11/2014
Last updated
08/11/2014
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