Provider Demographics
NPI:1982072575
Name:ALLEN, KATELYN (MSW)
Entity Type:Individual
Prefix:MS
First Name:KATELYN
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 TUSCANY WAY APT 308
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8180
Mailing Address - Country:US
Mailing Address - Phone:508-768-5825
Mailing Address - Fax:
Practice Address - Street 1:320 TUSCANY WAY APT 308
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8180
Practice Address - Country:US
Practice Address - Phone:508-768-5825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-13
Last Update Date:2015-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical