Provider Demographics
NPI:1770235897
Name:ALLEN, TIERRA RAYONA
Entity Type:Individual
Prefix:
First Name:TIERRA
Middle Name:RAYONA
Last Name:ALLEN
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 1:7 RIVER EDGE RD
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-1325
Mailing Address - Country:US
Mailing Address - Phone:860-941-1428
Mailing Address - Fax:
Practice Address - Street 1:7 RIVER EDGE RD
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-1325
Practice Address - Country:US
Practice Address - Phone:860-941-1428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula