Provider Demographics
NPI:1346639309
Name:ALLEN, CHEYENNE C (BS)
Entity Type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:C
Last Name:ALLEN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:CHEYENNE
Other - Middle Name:C
Other - Last Name:BORJA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BAI
Mailing Address - Street 1:1215 SW G ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2544
Mailing Address - Country:US
Mailing Address - Phone:541-476-2373
Mailing Address - Fax:
Practice Address - Street 1:1181 SW RAMSEY AVE
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5835
Practice Address - Country:US
Practice Address - Phone:541-476-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor