Provider Demographics
NPI:1447581533
Name:ALLEN, ADRIANNE
Entity Type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 N DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-4332
Mailing Address - Country:US
Mailing Address - Phone:317-363-4803
Mailing Address - Fax:
Practice Address - Street 1:5810 LEE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46216-2109
Practice Address - Country:US
Practice Address - Phone:317-543-9430
Practice Address - Fax:317-543-9497
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004742A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist