Individual
THOMAS M ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD, HSPP
Contact information
Practice address
1700 LINCOLNWAY PL STE 8, LA PORTE, IN 46350-3194
(219) 898-5645
(219) 325-0855
Mailing address
1700 LINCOLNWAY PL STE 8, LA PORTE, IN 46350-3194
(219) 898-5645
(219) 325-0855
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
20042166A
IN
103TH0100X
Health Service Psychologist
071.007397
IL
103TH0100X
Health Service Psychologist
Primary
20042166
IN
103TH0100X
Health Service Psychologist
20042166A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200882550A
—
IN
Enumeration date
10/14/2005
Last updated
06/30/2023
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