Provider Demographics
NPI:1184449399
Name:BLAND, ALLISON RENE (LLPC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:RENE
Last Name:BLAND
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4693 YELLOW PINE LN
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49004-3762
Mailing Address - Country:US
Mailing Address - Phone:269-986-7563
Mailing Address - Fax:269-344-8282
Practice Address - Street 1:1608 LAKE STREET
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-3170
Practice Address - Country:US
Practice Address - Phone:269-986-7563
Practice Address - Fax:269-341-8282
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6451016910101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health