Provider Demographics
NPI:1285034454
Name:ALLEN, KRISTEN MARIE (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MARIE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MISS
Other - First Name:KRISTEN
Other - Middle Name:MARIE
Other - Last Name:VOKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 SE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARE
Mailing Address - State:MI
Mailing Address - Zip Code:48617-9201
Mailing Address - Country:US
Mailing Address - Phone:989-386-7723
Mailing Address - Fax:989-386-4100
Practice Address - Street 1:600 SE 4TH ST
Practice Address - Street 2:
Practice Address - City:CLARE
Practice Address - State:MI
Practice Address - Zip Code:48617-9201
Practice Address - Country:US
Practice Address - Phone:989-386-7723
Practice Address - Fax:989-386-4100
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008423225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist