Deatherage, Allison Marie
Deatherage, Allison Marie is an sole proprietor health care provider with primary practice located at 204 W Hill Blvd , Charleston Afb SC 29404-4704. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Deatherage, Allison Marie can be contacted via phone (843) 963-6852.Contact Information
Primary practice address
204 W Hill Blvd
Charleston Afb SC 29404-4704
Phone: (843) 963-6852
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 7351 | Ohio |
Profile Details
| NPI number | 1659585099 |
|---|---|
| LBN Legal business name | Deatherage, Allison Marie |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 9th, 2007 |
| Last updated | Nov 20th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659585099 | NPPES |
| Ohio | MEDICAID | 2614899 |
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