Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6803085416 | MI |
NPI | 1003192725 |
---|---|
Provider Name | Ms. Celeste Patricia Allen |
First Address | Commerce Township, MI 48390-2805 |
Second Address | Southgate, MI 48195-2507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2011 |
Last Update Date | 26/10/2011 |