Provider Demographics
NPI:1477623387
Name:ALLEN, ESTHER LOUISE (DT)
Entity Type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:LOUISE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 NO. TIFFIN
Mailing Address - Street 2:
Mailing Address - City:WEST TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47885
Mailing Address - Country:US
Mailing Address - Phone:812-533-0045
Mailing Address - Fax:812-533-9935
Practice Address - Street 1:2150 N. TIFFIN
Practice Address - Street 2:
Practice Address - City:WEST TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47885
Practice Address - Country:US
Practice Address - Phone:812-533-0045
Practice Address - Fax:812-533-9935
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist