Provider Demographics
NPI:1891989646
Name:ALLEN, CAITLIN NMI (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:NMI
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF PEDIATRICS 138 LEADER AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40506-9983
Mailing Address - Country:US
Mailing Address - Phone:859-323-2089
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF PEDIATRICS 740 S LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0847
Practice Address - Country:US
Practice Address - Phone:859-257-8992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2733103TC0700X, 103TM1800X
KY169254103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities