Provider Demographics
NPI:1821756461
Name:ALLAN, NICHOLAS PAUL
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:PAUL
Last Name:ALLAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 OHIO UNIVERSITY DEPT OF
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2979
Mailing Address - Country:US
Mailing Address - Phone:740-593-0902
Mailing Address - Fax:740-593-4790
Practice Address - Street 1:1 OHIO UNIVERSITY DEPT OF
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2979
Practice Address - Country:US
Practice Address - Phone:740-593-0902
Practice Address - Fax:740-593-4790
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08227103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical