Individual
DR. ROGER DEAN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
301 E CHURCH ST, ELIZABETH CITY, NC 27909-4805
(252) 338-8821
(252) 338-8821
Mailing address
PO BOX 303, ELIZABETH CITY, NC 27907-0303
(252) 338-8821
(252) 338-8821
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
HSPP0954
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03119
BLUE CROSS BLUE SHIELD
NC
05
—
6000148
—
NC
01
—
94483
MEDCOST
NC
Enumeration date
10/31/2005
Last updated
10/26/2011
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