Provider Demographics
NPI:1689380891
Name:ALLEN, AKELA (RBT)
Entity Type:Individual
Prefix:
First Name:AKELA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 INVITATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48363-2455
Mailing Address - Country:US
Mailing Address - Phone:248-245-8728
Mailing Address - Fax:248-927-5070
Practice Address - Street 1:1175 W LONG LAKE RD STE 102
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-4443
Practice Address - Country:US
Practice Address - Phone:248-245-8728
Practice Address - Fax:248-927-5070
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician