Provider Demographics
NPI:1548532633
Name:ALLEN, CHRISTEEN (PSYD)
Entity type:Individual
Prefix:
First Name:CHRISTEEN
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 44726
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20749-4726
Mailing Address - Country:US
Mailing Address - Phone:301-908-7671
Mailing Address - Fax:301-567-0373
Practice Address - Street 1:616 CHARLES ST
Practice Address - Street 2:SUITE 103
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-5937
Practice Address - Country:US
Practice Address - Phone:301-908-7671
Practice Address - Fax:301-567-0373
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02558103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist