Individual
CARLOS DEWAYNE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1864 ATMORE DR, SAINT LOUIS, MO 63136-3334
(314) 388-0726
Mailing address
1864 ATMORE DR, SAINT LOUIS, MO 63136-3334
(314) 388-0726
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/16/2010
Last updated
02/16/2010
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