Provider Demographics
NPI:1336126341
Name:ALLAN, JOHN J (MA, PCC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:ALLAN
Suffix:
Gender:M
Credentials:MA, PCC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3974 BOARDMAN CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9043
Mailing Address - Country:US
Mailing Address - Phone:330-533-6767
Mailing Address - Fax:330-533-1665
Practice Address - Street 1:3974 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9043
Practice Address - Country:US
Practice Address - Phone:330-533-6767
Practice Address - Fax:330-533-1665
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE4137101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health