Provider Demographics
NPI:1508592726
Name:ALLISON, DEANA VIOLET
Entity Type:Individual
Prefix:MISS
First Name:DEANA
Middle Name:VIOLET
Last Name:ALLISON
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 1:52318 BRUSHY CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:JERUSALEM
Mailing Address - State:OH
Mailing Address - Zip Code:43747
Mailing Address - Country:US
Mailing Address - Phone:740-238-6507
Mailing Address - Fax:
Practice Address - Street 1:52318 BRUSHY CREEK ROAD
Practice Address - Street 2:
Practice Address - City:JERUSALEM
Practice Address - State:OH
Practice Address - Zip Code:43747
Practice Address - Country:US
Practice Address - Phone:740-238-6507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services