Provider Demographics
NPI:1487631438
Name:MCKOWN-ALLISON, COLLEEN (LSW)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:MCKOWN-ALLISON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 BOUGAINVILLE DR
Mailing Address - Street 2:PMB: 401
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-3179
Mailing Address - Country:US
Mailing Address - Phone:507-581-6797
Mailing Address - Fax:
Practice Address - Street 1:4725 BOUGAINVILLE DR
Practice Address - Street 2:PMB: 401
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-3179
Practice Address - Country:US
Practice Address - Phone:507-581-6797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40769104100000X
HI1716104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker