Tedra Allen

NPI #1174064745 in Portage, Michigan

Provider Information

NPI Number: 1174064745
Entity Type: Individual
Name: Tedra Allen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 16, 2017
Last Updated: Mar 16, 2017

Practice Location

Address: 1617 E MILHAM AVE
Address 2: SUITE B
City: Portage
State: Michigan
ZIP Code: 49002-3049
Phone: (269) 303-5931

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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