Most Relevant Information
Provider Data
| NPI Number: | 1003023680 |
| Provider Name: | ANTHONY JEROME ALLEN AAS., CAC II |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 820202 |
Most Important Dates
| Enumeration Date: | 05/16/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
12010 LINWOOD ST
DETROIT
MI
482061108
Practice Location Phone/Fax
| Phone: | 3138671090 |
| Fax: | 3138670706 |
Provider Mailing Location
5113 BANGOR ST
DETROIT
MI
482101760
Provider Mailing Phone/Fax
| Phone: | 3138671090 |
| Fax: | 3138670706 |