Provider Demographics
NPI:1164749347
Name:HARTZOGE, ALLISON HOPE (MA, BCN, LPC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:HOPE
Last Name:HARTZOGE
Suffix:
Gender:F
Credentials:MA, BCN, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 W TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-6169
Mailing Address - Country:US
Mailing Address - Phone:432-682-2724
Mailing Address - Fax:432-682-2725
Practice Address - Street 1:1005 W TEXAS AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6169
Practice Address - Country:US
Practice Address - Phone:432-682-2724
Practice Address - Fax:432-682-2725
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64291101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional