Doctor Name: | MS. MICHELE BASIE ALLEN |
NPI Number: | 1083796924 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 3650 |
Business Practice Address: | 904 Desoto St Ocean Springs, MS - 395643737 |
Business Phone Number: | 2288728429 |
Business Fax Number: | 2288720226 |
Mailing Address: | 904 Desoto St, OCEAN SPRINGS |
State: | MS |
Postal Code: | 395643737 |
Phone Number: | 2288728429 |
Fax Number: | 2288720226 |
NPI Enumeration Date: | 10/19/2006 |
NPI Last Update Date: | 03/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 3650 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |