| Doctor Name: | FRED ALLEN |
| NPI Number: | 1063431443 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LISW |
| License Number: | I-7931 |
| Business Practice Address: | 28 E Rahn Rd Sutie 105 Kettering, OH - 454295461 |
| Business Phone Number: | 9374346840 |
| Business Fax Number: | 9372641101 |
| Mailing Address: | 631 Kenwood Ave., CLAYTON |
| State: | OH |
| Postal Code: | 45415 |
| Phone Number: | 9372771592 |
| Fax Number: | |
| NPI Enumeration Date: | 07/18/2006 |
| NPI Last Update Date: | 07/19/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | I-7931 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |