Provider Demographics
NPI:1356653885
Name:ALLEN, CYNTHIA D (MED LPC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:D
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 N HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-3709
Mailing Address - Country:US
Mailing Address - Phone:580-482-2809
Mailing Address - Fax:580-482-6296
Practice Address - Street 1:319 N HUDSON ST
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-3709
Practice Address - Country:US
Practice Address - Phone:580-482-2809
Practice Address - Fax:580-482-6296
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional