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1003023680
ANTHONY JEROME ALLEN
DETROIT, MI
NPI
1003023680
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MI 820202)
Enumeration Date
2007-05-16
Last Update Date
2007-07-08
Business Address
-- ANTHONY JEROME ALLEN AAS., CAC II
12010 LINWOOD ST
DETROIT, MI 48206-1108
Phone number: 313-867-1090
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Mailing Address
-- ANTHONY JEROME ALLEN AAS., CAC II
5113 BANGOR ST
DETROIT, MI 48210-1760
Phone number: 313-867-1090
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