Provider Demographics
NPI:1194449900
Name:ALLEN, JENNIFER ASHLEIGH (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ASHLEIGH
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19623 REMINGTON CREST CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-2978
Mailing Address - Country:US
Mailing Address - Phone:832-640-9091
Mailing Address - Fax:
Practice Address - Street 1:41 PERIMETER CTR E STE 250
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30346-1902
Practice Address - Country:US
Practice Address - Phone:770-871-3159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT86131133V00000X
GALD005778133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered