Provider Demographics
NPI:1336697325
Name:ALLISON, AMBER (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:ALLISON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 1/2 PATTERSON DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-1015
Mailing Address - Country:US
Mailing Address - Phone:225-921-1825
Mailing Address - Fax:
Practice Address - Street 1:2901 N I 10 SERVICE RD E
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6137
Practice Address - Country:US
Practice Address - Phone:504-780-1702
Practice Address - Fax:504-780-1705
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1369103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist