Provider Demographics
NPI:1467851519
Name:ALLOUANE, JAMILA (LICSW)
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:
Last Name:ALLOUANE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:JAMILA
Other - Middle Name:
Other - Last Name:ALLOUANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:120 WAYLAND AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4318
Mailing Address - Country:US
Mailing Address - Phone:301-646-3608
Mailing Address - Fax:
Practice Address - Street 1:120 WAYLAND AVENUE SUITE 2
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906
Practice Address - Country:US
Practice Address - Phone:301-646-3608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW025751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical