Provider Demographics
NPI:1134390339
Name:ALLANKETNER, ANNE (MA LPC MFT)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:ALLANKETNER
Suffix:
Gender:F
Credentials:MA LPC MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 VIEW LN
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2314
Mailing Address - Country:US
Mailing Address - Phone:541-343-3062
Mailing Address - Fax:
Practice Address - Street 1:3400 VIEW LN
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2314
Practice Address - Country:US
Practice Address - Phone:541-343-3062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLPC C1976101YP2500X
CAMFC 18959106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist