Provider Demographics
NPI:1255776423
Name:ALLEN, EASTON ERROL I
Entity type:Individual
Prefix:MR
First Name:EASTON
Middle Name:ERROL
Last Name:ALLEN
Suffix:I
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 1:7022 OAKLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-2935
Mailing Address - Country:US
Mailing Address - Phone:702-743-0527
Mailing Address - Fax:
Practice Address - Street 1:3636 LAS VEGAS BLVD N
Practice Address - Street 2:SUITE B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-1555
Practice Address - Country:US
Practice Address - Phone:702-776-8397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor