Individual
ECCLESIASTES ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, PIP
Contact information
Practice address
284 DOUGLASS RD NW, HUNTSVILLE, AL 35806-2280
(256) 617-3845
Mailing address
284 DOUGLASS RD NW, HUNTSVILLE, AL 35806-2280
(256) 617-3845
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2145-C
AL
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
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