Provider Demographics
NPI:1952168494
Name:ALLEN, SIOBHAN PATRICIA
Entity Type:Individual
Prefix:
First Name:SIOBHAN
Middle Name:PATRICIA
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3244 VINE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-2627
Mailing Address - Country:US
Mailing Address - Phone:402-309-3585
Mailing Address - Fax:
Practice Address - Street 1:4719 PRESCOTT AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5456
Practice Address - Country:US
Practice Address - Phone:402-413-9147
Practice Address - Fax:402-261-7149
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13810101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health