| NPI | 1932570942 | 
|---|---|
| Former Name | WILLIE EUGENE ALLEN | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: LA PLC9419) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA PLC9419) | 
| 171M00000X Case Manager/Care Coordinator (Licence: LA PLC9419) | |
| Enumeration Date | 2015-10-16 | 
| Last Update Date | 2024-03-27 |