Provider Demographics
NPI:1467625582
Name:ALLRED, ANTHONY SCOTT
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:SCOTT
Last Name:ALLRED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54-018 HAUKOI PL
Mailing Address - Street 2:
Mailing Address - City:HAUULA
Mailing Address - State:HI
Mailing Address - Zip Code:96717-9529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45-021 LIKEKE PL
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2426
Practice Address - Country:US
Practice Address - Phone:808-236-2288
Practice Address - Fax:808-247-4032
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist